Edward D Shanshala II, MSHSA, MSEd is the CEO of Ammonoosuc Community Health Services, Inc. (ACHS), in rural New Hampshire. Ed serves on the board of BI-State PCA, is Board President of the North Country Health Consortium, and is the co-founder of three accountable care organizations. His career has spanned pharmacology research, patient-centered re-engineering at an academic medical center, leading a strategic response to home health and hospice payment reform, providing leadership at both rural and urban FQHCs as well as writing curriculum and teaching in a variety of adjunct professorial roles at Rochester Institute of Technology, Keuka College, and Roberts Wesleyan College.