Over the past several years, provider and hospital reimbursement in the U.S. health care system has begun a shift from a volume-based model toward a value-based model. This movement to value-based reimbursement is accompanied by both revived and new interest in alternate payment mechanisms such as pay-for-performance, shared savings programs, bundled payments, and capitation models. This chapter reviews the current landscape of health care reimbursement, the challenges associated with various payment models, and the practical aspects associated with adapting an organizational model and the clinical practice structure in this evolving payment environment.