However the Trump administration and the Republican U.S. Congress replace or revamp the Affordable Care Act, it is unlikely to halt America’s ongoing move from the rightfully maligned fee-for-service payment system to one that pays for “value” — the quality of outcomes relative to the price. Despite the progress that’s been made, there is still a long way to go. What new investments will be required? What legacy costs will be incurred as providers strive to optimize their business processes to deliver comprehensive value-based health care? How will leadership teams and boards of directors orchestrate the strategic transformations of their currently successful businesses?