Fee-for-service revenue remains dominant among healthcare provider organizations, but leaders expect a shift to value-based payment models over the next few years. They are testing models such as shared savings, bundled payments, and shared risk. The true degree of risk in these arrangements is unknown, as are the specific outcomes of the different models. Financial executives are challenged to make the right bets and to be sure their organizations have the necessary skills. The coming years are a bridge between the fee-for-service present and the pay-for-performance future, during which leaders must ensure their organizations' financial viability.