Declining termination rates and margin compression are major challenges for VoIP routes providers. Network infrastructure and routing costs remain high while competition is increasing. Providers must adapt to shifting consumer preferences toward OTT voice apps and ongoing PSTN switch-offs. Staying on top of rapidly changing technology like virtualization and cloud delivery requires investment. Growing security threats like fraud and hacking must be addressed. Offering differentiated quality of service is more important than ever. Markets and regulations continue to fragment globally. To survive, VoIP routes providers must innovate their business models, optimize operations, focus on the highest value routes and deliver outstanding voice quality.