After years of talking about the transition from fee-for-service to value-based payment, most provider organizations are still waiting for the tipping point. Increasingly, the future revenue picture looks like a combination of both payment models, with some revenue coming through value-based arrangements, but much fee-for-service remaining. This will pose an enormous challenge for healthcare leaders, who must figure out how to evolve and thrive at the same time—how to ensure their organizations get paid enough, how fast they should shift to ambulatory and outpatient care, and how best to restructure toward accountable care and population health management.