Today's nurse executive is likely to find himself or herself in the middle of a merger, acquisition, and/or partnership (MAP). This is the result of health care agencies vying for market share in the midst of stiff competition, as well as decreased reimbursement in a rapidly changing payment system. The phenomenon of MAPs is fueled by the focus on care coordination and population health management. To be prepared for the ongoing and increasing MAP activity, nurse executives need to develop the skill of risk taking as an essential competency for leading change. This article emphasizes the need to maintain and improve health care quality and patient safety.