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Spokane is an integrated market that serves as a healthcare hub for the Inland Northwest and draws patients from rural areas and nearby states. The market has seen a flurry of merger and acquisitions over the last year. Its two largest health systems have both undergone mergers, and Kaiser Permanente entered the market by purchasing Group Health Cooperative, a local health plan and provider group. Kaiser’s entrance could urge Providence St. Joseph Health or MultiCare to consider forming their own health plans to compete.