American Colleges and Universities are continuously challenged to increase access to higher education, improve the quality of student learning, and control or reduce the rising cost of instruction. These challenges are interrelated. As tuition costs continue to rise, access is curtailed. When high failure rates prevent students from successfully completing courses and programs, promises of increased access become hollow. Solutions to these challenges appear to be interrelated as well. Historically, either improving quality or increasing access has meant increasing costs. Reducing costs, in turn, has meant cutting quality, access, or both. In partnership with 30 colleges and universities, the National Center for Academic Transformation (NCAT) has proven that it is possible to improve quality and reduce cost in higher education. Course redesign using information technology is key. Recommendations include: (1) establishing redesign programs; (2) demanding accountability; and (3) building incentives.