Volume to Value or V2V continues to move aggressively in many markets. Among the most challenging aspects of our cardiovascular practices (be they independent, academic, or integrated) is payment reform. In a value based paradigm, reimbursement models continue to be tried and vetted. This session will review the more common MSSP ACO, BPCI (bundled payment), and other innovative attempts to more closely align reimbursement to the triple aim - better patient outcomes at lower cost with great patient experience. Our presenters will bring "in the trenches" words of wisdom as we gather more experience with different payment models.