Value-Based Healthcare (VBH) is the most transformative healthcare reform effort in decades, dramatically changing how physicians engage and are compensated within patient care. CMS has targeted conversion of Medicare and Medicare Advantage plans to be 100% alternative payment models within for specialists and primary care by 2030. CMS has launched a value based care reboot in 2023 and will be presenting voluntary and mandatory programs for specialist value-based payment participation that will roll out between 2025 - 2029. CMS is designing a platform to collect data on specialists to "inform referrals" within ACO's and primary care that will be value-based to enhance shared savings program performance. Within APM's, specialist episode-of-care costs will increasingly impact referrals as value is measured and reported within alternative payment models. Otolaryngology is not presently on the forefront of VBH change, however value-based accountable care organizations and CMS are collecting claims data that will determine future referrals. Understanding the concepts within VBH and proactively identifying areas of opportunity to engage this evolving process will be important to prevent third-party determination of future Otolaryngology value-based care (VBC) models. The goals of this presentation are to explore the components of VBH, highlight the current and future VBC strategies and programs from payers, and discuss areas within otolaryngology where research efforts and strategic planning can proactively develop Otolaryngology VBH opportunity zones.