AMA Journal of Ethics theme editor Amanda Xi, MD, a transitional year resident at Henry Ford Hospital, interviewed Donald M. Berwick, MD, shortly before the Supreme Court's decision in King versus Burwell. Dr. Berwick discussed progress in meeting the health care goals of the ACA and the Institute for Healthcare Improvement and next steps for improving patient care. A former head of the Centers for Medicare and Medicaid Services, Dr. Berwick is a senior fellow and president emeritus at the Institute for Healthcare Improvement.