While clinical laboratory testing as a diagnostic tool continues to grow in influence and importance to the majority of medical decision making, ongoing changes in the health care industry are providing new challenges, including disruptive business models and technology, engaged and cost-conscious consumers, and changing payment models. With the nationwide movement toward value-based payment systems, health system clinical laboratories have an opportunity to shed the traditional volume-driven laboratory model and take the lead in demonstrating how appropriately leveraged diagnostics can improve patient outcomes and lower the overall cost of care. Making such a transition demonstrates value, and it is increasingly risky for a laboratory to function without doing so.