Driven by ongoing market pressures, consolidation continues to be a dominant trend in Worcester. Independent health systems and hospitals are partnering to gain influence, while the sector 's dominant systems continue efforts to drive clinical integration and care coordination, including partnering with public and private insurers on alternative payment arrangements. Tufts Health Plan and Harvard Pilgrim Health Care have agreed to merge their organizations into a new company to achieve scale and cost-efficiencies, while physicians are taking the lead in developing ambulatory surgery centers to gain more control over their surgical practices. Massachusetts has advanced a plan to control drug costs that will have a negative impact on some of the most expensive drugs purchased through the state's Medicaid programs.

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