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Greenville Health System and BlueCross BlueShield of South Carolina are the market's top two players. GHS' recent partnership with Palmetto Health has created the largest health system in the state, pushing competitors, such as Spartanburg Regional Health System and AnMed Health, to distinguish themselves with top-quality care and geographic convenience. The South Carolina Blue plan dominates the health plan sector; it leads in the the creation of patient-centered medical homes in the market and is the only perticipant on the state's health insurance exchange. The market's top health systems are targeting patients with chronic conditions, such as obesity, diabetes, and heart disease, to try to combat the state's high prevelance of these conditions and the high costs associated with them. The state has not participated in Medicaid expansion, and with only one carrier remaining on the exchange and the end of the individual mandate in 2019, it faces a high-and-rising uninsured rate, which does not bode well for drug utilization rates.