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The Orange County market is the state’s epicenter for healthcare reform and innovation. UnitedHealth Group’s Optum unit continues to buy physician organizations, with its most recent purchase being DaVita Medical Group, which includes local large IPA HealthCare Partners. Powerhouse Providence St. Joseph Health system is pursuing further clinical integration following its 2016 merger. Providers in this market are moving fast toward innovative pay-for-value designs to compete with Kaiser Permanente. Expect this trend to continue into 2018 with Orange County providers and insurers teaming up in more novel risk arrangements.