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Florida’s most traditional healthcare market, Jacksonville health systems continue to rely on hospital construction and physician affiliation to increase clout against payers and gain patient volume. While each health system has pending construction plans, the market is becoming more accepting of ACOs and narrow networks, with multiple agreements between leading health systems and major insurers. As the market reaches a saturation point for hospitals, local health systems are working more closely with physicians to create clinically integrated networks, which increase care coordination and population health management capabilities, allowing the health systems to work with insurers on value-based contracts. Should the current arrangements between health systems/physicians and insurers improve outcomes and the organizations’ bottom lines, it could encourage greater acceptance of narrow networks and risk-based contracting.