Providers and payers have initiated new activities to ensure that the implementation of new payment models are driving improvements in the quality of care and reducing health care costs. In February 2014, Robert Wood Johnson Foundation payment reform grantees met with experts from across the country to explore these new activities and share their experiences and best practices. The primary focus of the meeting was on provider-based activities that were making a difference in terms of systems transformation. This brief summarizes the selected innovations described by presenters during the meeting and draws lessons from providers and insurers on the ground. The brief also identifies characteristics that position organizations for success in these efforts.