Building scale within your organization is critical to long-term success. This is true regardless of the size, scope of service, or market share of your health system or provider group. In a value-based world, cardiology practices or CV service lines that are able to achieve scale through internal growth or strategic partnerships with other organizations will be best positioned to offer accessible, highquality, and cost-effective care—all of which are critical in today’s healthcare environment. As prefaced in our two previous columns, to thrive in the value-based world, hospitals and physician groups need to work together to become optimally (1) integrated, (2) scaled, (3) rationalized, (4) informed, and (5) responsive. This column focuses on the attribute of scale. More specifically, we discuss the perceived barriers, potential benefits, and methods used to achieve scale.