Through the episode payment models, hospitals and clinicians are financially responsible for expenses incurred during index hospitalization as well as in the prehospitalization and posthospitalization periods. Coordinated and efficient care allows hospitals to be competitive with regard to this payment model, but the challenge is to deliver care that guarantees access and quality within the budgetary constraints. Payments should be fair and practical if the intended goal is value-based care and not just cost containment.