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The movement of U.S. health care to value-based payment presents a critical opportunity to improve accountability for the quality of serious illness care, while constraining the growth of spending. The changing incentives in the health care system are driving innovation in the delivery of serious illness care in traditional Medicare, Medicare Advantage and commercial plans. Implementation of an accountability system for serious illness care is vital for ensuring that cost containment efforts do not result in undertreatment or worse quality of care for the seriously ill.In May 2017, the Gordon and Betty Moore Foundation convened 45 serious illness care experts and stakeholders - such as physicians, researchers, patient advocates, policy experts - in Banff, Alberta, Canada, to identify a path forward for building an accountability system for high-quality, community-based serious illness care programs. The group reached consensus on a definition of the serious illness population, the necessary components of an accountability system and guiding principles for quality measurement. In addition, convening participants identified a starter set of quality measures, future pathways for implementation of an accountability system and needed future research.