Transformation is necessary if an organization intends to survive in the new healthcare environment. Healthcare reform is a reality. Addiction services providers have an unprecedented opportunity to expand services and access for the 23 million people who had no access previously. While the most significant changes will not take place until 2014, many changes are occurring now. It is not too late (nor too early) to begin systems transformation efforts. However, organizational transformation will not occur overnight. It will take extensive thought, planning, and implementation. Organizations that wait will find themselves behind the power curve, potentially losing opportunities to.