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UPMC Health and Highmark Health, Pittsburgh's two main provider/payer networks, will no longer accept members from the rival insurer as in-network when the state-negotiated consent decree ends on June 30, 2019. The post-decree landscape could give added leverage to the market's few independent health systems, some of which have formed a clinically integrated network called Bridges Health Partners. National insurers like Aetna, UnitedHealthcare, and Cigna, also could gain members for products that include both Highmark's Allegheny Health Network and UPMC facilities in their network. Expect the current market, largely divided between UPMC and Highmark, to include more smaller players that attract patients with lower costs and added services.