A growing number of health care employers have made substantial investments in the skill and career growth of their frontline staff—many of whom spend the most time with patients, taking vital signs, bringing meals, changing linens, and registering them into or out of the hospital or clinic. Iowa’s UnityPoint Health, a leader in developing frontline workers, is committed in transforming the way it delivers care. UnityPoint Health’s Des Moines hospitals and clinics are showing that it is possible to connect the dots between developing a skilled workforce and delivering better care. While this process is far from finished, UPH offers valuable lessons in aligning talent development with business objectives in the age of the Affordable Care Act. This is a case study of UnityPoint Health and its effort to transform care, develop frontline workers, and fully align these objectives in its Des Moines hospitals and outpatient clinics.