This presentation will cover the unique issues that face independent providers in the value based care from the Independent Physician Advisory perspective. This includes Physicians of Southwest Washington journey to successfully align independent providers, multi-specialty  groups,  hospital partners, and post-acute community providers  in up and down-side payer risk models.  PSW was able to qualify the network of providers as an Advanced Alternative Model under MACRA rule in  CMS Next Generation ACO model.  Will discuss the challenges and opportunities to use data from multiple E.H.Rs  and engage providers in action to improve quality and reduce costs.