If value-based care (VBC) is no longer a mystery, there is an opportunity to address some of the challenges the industry faces when scaling VBC to help ensure its success. This fireside chat examines where many of the challenges lie with VBC at the intersection of data, incentives, and clinical reality—well beyond what dashboards reveal. Drawing on real-world payer and provider experience, this conversation surfaces the decisions leaders are making and the designs they are considering that separate early success from sustained impact. The result of this chat will be a grounded, honest look at what it takes to make VBC stick when the data is messy and the stakes are high.