This chapter discusses the evaluation of health services from a value-based health care (VBHC) perspective. First, we introduce the key principles of VBHC. Second, as the healthcare systems vary worldwide, we discuss the main system-level factors affecting value-based approaches. A system-wide approach is essential, as the long-term sustainability relies on shared goals across the entire health system. As an example, payment models, government regulations, and digital infrastructure may support or hinder the development of value-based care. The sections in this chapter will consider the evaluation of health services focusing on key VBHC goals: maturity of VBHC, outcomes, and costs. We introduce various perspectives, methods, and tools for both internal and external evaluation of health services. Finally, we discuss the challenges related to VBHC.