Baltimore healthcare stakeholders took on the initial stages of the COVID-19 pandemic armed with research from the market prestigious academic health systems. The pandemic spurred the largest healthcare organizations to share data and communication strategies as well, paving the way for closer alignment in the future. Other integrated delivery networks stepped up their telemedicine and home health services, while all systems worked together to manage the flow of COVID-19 patients. Payers and providers, meanwhile, adjusted to Maryland reimbursement model, the Total Cost of Care Model, which puts care for Medicare beneficiaries at risk and builds on state-guided reimbursement strategies that set global payments for the rates insurers pay hospitals. While Maryland cost-containment efforts impacted the growth rate for medical costs, the Total Cost of Care model seeks to do more by introducing coordinated population health efforts across the market. The model also encourages value-based/population health partnerships between Maryland largest insurer, CareFirst BlueCross BlueShield, and two major IDNs, University of Maryland Medical System and MedStar Health. Both IDNs recently sold government-sponsored plans, while Johns Hopkins Medicine still operates commercial, Medicare, and Medicaid plas and MedStar still operates a managed Medicaid plan. Expect more partnerships between CareFirst and Baltimore providers, encouraging health systems like Johns Hopkins to examine the benefits of accepting risk for both patients and members.