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The Toledo market continues to be driven chiefly by two large health systems: ProMedica Health System and Mercy Health, and they employ the two largest physician groups in the area. ProMedica, the market leader, also owns Paramount Health Care, a popular health plan that continues to give ProMedica a leg up on its competition. While these factors mean that Toledo’s healthcare market dynamics have not changed much in the last several years, several of ProMedica’s competitors have formed partnerships on specialty-care initiatives. Watch for the Toledo market to benefit from two massive financial deals that occurred within the last year—ProMedica’s acquisition of HCR ManorCare and Mercy’s merger with Maryland-based Bon Secours Health—which should further separate the two massive health systems from the rest of the Toledo market and heighten the healthcare arms race already underway.