Healthcare reform at the federal and state levels is spurring the shift from volume to value, demanding providers to coordinate care across the healthcare spectrum. Public and commercial payer pressures, combined with new health insurance designs that demand a more engaged consumer, in part have spurred this shift. Value-based payment models move away from historical fee-for-service and tie payment to cost and quality standards. These models offer providers opportunity, but not without financial risk. Many New York hospitals are successfully participating in these models and many more will as state, federal, and commercial payer reforms continue. HANYS has expertise in all of the various value-based payment models and is engaged in ensuring these models are workable for all, regardless of where providers sit on the readiness spectrum.