In the management of the pulmonary arterial hypertension (PAH) patient, the use of risk assessment algorithms has become de rigueur for the regular determination of disease progression and the effectiveness of treatment. However, based on the registries, from which the modern risk assessment models have been developed, it’s clear that the majority of patients fall into the intermediate-risk category. And yet, within this broad category, there’s a spectrum of disease severity, medical treatment need, and survivorship. Using risk assessment effectively in the modern era will rely on a rethinking of how to use risk assessment and adjusting disease management strategies appropriately. This program explores new ideas in the use and application of risk assessment protocols and the impact these have on the use of multimodal, combination therapy and lung transplantation.