Regional accreditation, the "gold standard" of higher education institutional quality, has been around at least since the 1850s (Ewell 2008). In "U.S. Accreditation and the Future of Quality Assurance," Ewell (2008) describes four distinct periods in the history of accreditation in the United States, which range from defining a college to the current age of accountability. Many suggest that the United States is entering a fifth period of redesign that refocuses accreditation compliance from an evaluation of institutional resources and internal operations to a distinct emphasis on outcomes. This article describes the redesign that is occurring at the Southern Association of Colleges and Schools Commission on Colleges (SACS COC), one of the six regional accrediting associations, and the national implications of this redesign. Specifically, the article outlines some of the important changes in regional accreditation and their projected impact on institutional planning. (Contains 4 figures and 1 note.)