The case study examines the journey toward value-based healthcare at Karolinska University Hospital. The hospital's ambitious shift to a patient-centered care delivery model, accompanied by the construction of a new facility, encountered challenges such as high costs, staff dissatisfaction, and growing waiting lists. The departure of CEO Melvin Samsom in 2018 left the new director Bjorn Zoega with a budget deficit, discontented staff, and an outdated IT system. By 2023, however, Zoega had achieved a remarkable turnaround. Ranked among the top 6 international hospitals, the institution boasted a positive budget and had exceeded production assignments for three consecutive years. In 2023, Zoega pondered if his changes were long-lasting and how the Hospital should face new challenges such as an aging population and a shortage of qualified nurses.