Employers, payers, and consumers are demanding greater accountability and higher value for their health care spend. As a result, commercial and governmental payers are developing new payment models that are increasingly focused on the value of the care provided not the volume of services provided. We will describe the transformation that is underway and explore the various payment models being introduced into the market and explore the current trend in value-based payments designed to drive greater accountability from providers and the acceleration in risk based payment models.