Spoiler alert. The title of a recent column marking the 10th anniversary of Triple Aim efforts to move medical payment and delivery from volume toward value makes no bones about the effort’s shortcomings. This report card from the Triple Aim’s top cheer-leader is meaningful to the high touch, human-intensive movement for integrative health and medicine for one important reason: the field’s potential uptake is pegged to advance of the values orientation. Success is more broadly meaningful because the values-based war against the forces in the industry that causally associate it with 250,000 medical deaths each year – effectively medicine’s white walkers in Game of Thrones terms – is the bullseye point of reference on what is at stake.