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A market in flux, Memphis is seeing a power shift as the largest integrated delivery networks compete for commercially insured patients and narrow network contracts with both established and new insurers. Three new insurers will offer plans on the health insurance exchange for 2019 as the market's largest health systems work to increase patient access via physical and service expansions. The market’s clinically integrated networks are working to drive cost-savings and population health management through ACOs, a newly established telemedicine network, and value-based contracts, all initiatives that should improve drug adherence.