Critical to delivering high value care is understanding that it is not just about reducing costs. Instead, it's about ensuring that your treatment plan (and understanding of the problem) is tailored to the patient and what is important to them (i.e., PROMS). Shifting to a value-based system and focusing exclusively on cost (which of course is a fundamental element of VBHC) could potentially lead to worse outcomes for our most vulnerable patients. We need to guarantee that our value-based practice models are responsive to diverse patient needs. The patient always comes first.