Recently, some rural health clinics (RHCs) throughout the country have chosen to join groups of health care providers in accountable care organizations (ACOs). Examined are characteristics of Southeastern RHCs and the counties they serve; it is shown how those characteristics compare with other regions across the country and suggested what role those differences might play in an RHC's decision to participate in an ACO. Rural health clinic-related data were collected and summarized for 2 time periods: 2007 and 2011: for 2007, data from RHCs throughout the United States; for 2011, summarized demographic data related to region 4 RHCs specifically. Several characteristics about region 4 RHCs indicate that they may be slow to participate in ACOs. However, other characteristics, including their perception that ACOs may improve the quality of care and health outcomes of their patients and communities, may facilitate the process of RHCs joining ACOs, should they choose to do so. Addressing the health care needs and health care quality of rural populations must be part of the design, development, and performance monitoring of ACOs of the future.