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The shift from volume to value is happening at the provider level, where health systems and clinically integrated networks drive innovation. Clinically integrated networks have received millions of dollars in shared savings through their ACOs. BayCare Health System, Tampa General Hospital, and Moffitt Cancer Center are betting that the future of population health lies in artificial intelligence, which supports decision-making through data analysis. Health systems want to offer the latest in robotic surgery and want to be the convenient choice for emergent care. Tampa’s top payers, UnitedHealth Group and Florida Blue, may align with or negotiate to own physician groups. Health plan-owned groups can become primary-care gatekeepers to narrow network plans. It is a pre-emptive strike against direct contracting, in addition to controlling costs.