Healthcare Reform will be tumultuous in 2013 with multiple payment initiatives like Accountable Care Organizations (ACOs), value based purchasing or other models jockeying for position. Pharmacy's need for recognition and payment for clinical contributions and drugs requires core competency in strategic planning, budgets to increase revenue and decrease expense, managed care negotiations, Medicare/Medicaid payment systems and finding to support future practice models and PPMI. Selling new concepts to finance teams and defending against outside influences striving to reduce expenses is challenging. This presentation introduces concepts and continues discussions to assist in articulating the goals and values of pharmacy, and provides strategies for moving forward.