The 3rd Dimension brings together the 1st and 2nd Dimensions into a whole concept of a 3-Dimensional real space. Counterfactually a real space includes the actual and the possible. Value is itself actual when promulgated by existing data and provides a retrospective foundation for value based purchasing. Extending the scope of Value to include the counterfactual possibilities promulgates prospective Value. The Value potential is significantly greater if the entire healthcare ecosystem as real space, implements pathways to Value that originate organically in the moment of patient care events. Progress of pathways through the networks and populations returns to the moment as the destination most likely to create Value. To be clear pathways include information, which when created counterfactually becomes real, not abstract, and is just as exact as financial and clinical information captured in standard data systems.