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Jefferson Health and University of Pennsylvania Medicine are establishing themselves as the major healthcare delivery brands in Philadelphia, with each acquiring hospitals in the Philadelphia suburbs and in New Jersey. The dominant insurer continues to be local favorite Independence Blue Cross, which outlasted national rivals Aetna and UnitedHealth in the state's individual health insurance exchange and has an edge on the region's Medicaid population. As Jeff and Penn have bought up viable hospitals to fill holes in their respective service areas, both may be shifting focus to establishing more-convenient points of access, such as outpatient centers and post-acute care. IBC is also looking to engage more directly with patients and physicians through organizations like Tandigm Health. While Penn and Jeff may each add another local health system in the coming year, expect both to focus on adding population health management capabilities.