Value-based care is rapidly expanding beyond primary care with two landmark mandatory CMS models reshaping specialty care compensation in 2026-2027. The Transforming Episode Accountability Model (TEAM) holds hospitals accountable for five high-volume surgical procedures through 30-day bundled payment episodes. Building on this momentum, the Ambulatory Specialty Model (ASM) is the first mandatory value-based program for outpatient specialists, affecting cardiologists and pain/orthopedic specialists in designated areas. This marks a decisive shift from voluntary specialty participation to mandatory two-sided risk arrangements.