In healthcare, success often comes with scale, and value-based care is no different. Success depends on gaining market share to effectively manage risk for broader populations, but in a crowded market, this is easier said than done. VBC innovators are focused on designing unique, differentiated models that reward meaningful patient outcomes through accurate outcomes reporting and properly incentivizing providers to focus on prevention, all while they earn top patient satisfaction scores. For payors to support, they must be convinced to allocate more reimbursement dollars toward outcomes-based care, supported by data tracking that demonstrates the effectiveness of these models. Two-sided risk arrangements are already growing in prevalence, showing potential for aligning financial incentives with the delivery of high-quality care. However, new models replacing traditional systems are not without their critics and again, gaining market share in healthcare is hard and expensive. Lets examine emerging payment strategies and risk-sharing arrangements showing glimmers of success, so healthcare economics can be transformed to prioritize value, not volume.