With an ageing and increasingly heterogenous ICU patient population, reflection and evaluation of care planning and decision-making have never been more important. Value-based healthcare is regularly posited as the way forward. But one of the ongoing challenges of value-based healthcare lies in the terminology and its meaning. An invited commentary from 2020 unpacks this issue, including how value, and value-based healthcare are sometimes conflated with cost reduction, quality and patient satisfaction [1]. Whilst important, cost reduction, quality and patient satisfaction are not the only measures that deserve attention. This is exactly why we need to talk about values-based healthcare, which places emphasis on patient values, goals and preferences, what matters most [1], and what their values may mean for planning treatments and interventions [2].