Value-Based Care (VBC) is entering a moment of reckoning as purchasers demand measurable, scalable results from long-standing models. Employers and plans are reassessing which approaches truly deliver better outcomes and lower costs, while renegotiating risk and exiting underperforming arrangements. Additionally, in a recent survey, over 75% of health system CEOs indicated intent to increase VBC participation, up nearly 20% from the previous year. In 2026, VBC will be defined less by ambition and more by execution.