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Chicago providers are experienced with value-based contracting, yielding significant savings and quality improvements through their accountable care organizations. Payers are not letting uncertainty about healthcare reform stop reimbursement reform, and they are pushing for more cost controls through narrow networks and bundled payments. Health systems are expanding urgent-care clinics and multispecialty clinics throughout the market, offering convenience or access to specialty services, such as cancer treatment, women’s services, or chronic disease management. Significant health system mergers will shift the balance of power in Chicago, giving providers the ability to step up direct contracting and get higher rates from insurers. Greater encouragement of generics and preferred pharmacies will affect branded and specialty drugs, but better care coordination for chronically ill patients will increase uptake of drugs that treat chronic conditions.