Health centers are strongly positioned to achieve the Triple Aim – improved patient experience and population health, with reduced total health system costs per capita – within low-income and underserved populations nationwide. Payment reform efforts can align payments to support innovation and important resources for health centers to achieve their mission and address social determinants of health in their communities. Furthermore, payment reform that strengthens and supports the role of patient-centered primary care is critical to achieving the Triple Aim. This paper describes a framework for health centers to understand the role of payment reform in achieving the Triple Aim. The framework is composed of three facets. The first facet provides for more flexibility of service delivery within current health center payment; the second provides the investments to support delivery system transformation (including health centers serving as Patient Centered Medical Homes and Integrators); and the third facet provides incentive payments for performance on Triple Aim outcomes.