Project Summary In 2016, faculty from Johns Hopkins medicine invited all academic medical centers in the US to collaborate in creating the High Value Practice Academic Alliance (HVPAA), a multi-institutional, multispecialty organization designed to efficiently and effectively advance value-based quality improvement initiatives on a national scale. As of January 2022, more than 200 faculty leaders from 100 academic centers in the US and Canada serve as institutional or departmental representatives. Members convene on monthly conference calls for information sharing, organize the annual conference, collaborate on multicenter publications, and direct two free year-long high-value care professional development programs (Future Leader Program for trainees and VITAL for early- career faculty). This proposal requests support for the 5-7th annual Architecture of High Value Health Care national conferences. Since its inception, the annual conference has advanced more than 600 value-based quality improvements initiatives and fostered broad collaboration across academic centers. Presentations from the 1st four conferences contributed to a blueprint encompassing five key areas health systems must address to become genuinely high-value medical centers: (1) Diagnostic and therapeutic efficiency and effectiveness, (2) quality-driven care pathways to reduce unwarranted practice variability, (3) Care transitions and in particular hospital discharge, (4) Optimizing patient care setting and improving the caliber of ambulatory care, to reduce avoidable use of the emergency department and hospital, and (5) Preventative medicine to prevent disease and evidence-based screening from reducing late-stage diagnoses. For the following three conferences, we will prioritize equitable delivery of high-value care and interdisciplinary teamwork in addition. Presentations by medical students and trainees are prioritized, as their engagement ensures that value-based care will become the standard for future generations. Our Future Leaders Program bolsters this mission for trainees and the Value Innovation Teaching and Leadership Program (VITAL) for junior faculty. The conference is a critical component of these two programs by fostering a network of high-value care champions and building a foundation for their future success.