Deal-making and disruption are transforming relationships between providers and payers in the highly competitive Minneapolis market. The two largest hospital systems, Allina Health and Fairview Health Services, are rattling the payer landscape through growing insurance operations and plans to directly contract with employers. The market-leading Blue plan has responded by creating a joint venture that will take control of 20 North Memorial Health clinics in 2020. The rise of integrated delivery networks and a high concentration of large employers make Minneapolis an ideal proving ground for population health and payment reform initiatives. Minneapolis’ population is healthy but aging, leading to investments in therapeutic areas including orthopedics, neurology, and cancer. Sales for many branded drugs will suffer following the rollout of a uniform preferred drug list for public-program beneficiaries.

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