Robert Williams, MD, Director, Strategy & Operations, Deloitte Consulting, and Mark Golberg, Specialist Leader, Recombinant by Deloitte. The business model paradigm change initiated by the ACA has spawned a wave of convergence for providers and payers. While providers work to prepare for value based care, they cannot neglect their existing fee for service business operations. New metrics, analytics, and tools are required that can, but need not, undermine the fee for service business model. The presentation reviews the strategic, operating model, and technical IT implications of this transition, along with the current state of evolution in the marketplace.