The article discusses the use of accounting standards for public organizations, focusing on emerging frameworks and practices among Italian public care providers. The authors acknowledge the financial pressures and modernization requests that have led to an increased focus on performance information and the adoption of new accounting techniques. The article explores the options available to public organizations, including the choice to adopt a harmonized system or to leap-frog to pure accrual accounting. The authors suggest that the choice of accounting standards should be based on the specific needs and goals of the organization, as well as the requirements of current regulations.