Consolidation and construction have long characterized the rapidly growing Atlanta market, which has seen numerous mergers and acquisitions in recent years among both payers and providers. Emory Healthcare ranks first by market share for the first time in years, and Centene—which acquired WellCare in 2021—occupies second-leading payer position, rather than fifth. Power will continue to flux and fuel intensifying negotiations between payers and providers, as well as blurring of payer-provider lines. Although patient volumes continue to wax and wane from COVID-19—which hit Atlanta particularly hard—the outlook for prescription drug utilization and adherence remains high. Atlanta IDNs may make excellent partners on outcomes-based pharmaceutical contracts in the long term, given their clinically integrated network-centric operational models, but they will first need to gain more confidence and experience with risk-based payments.