Buffalo’s top health systems and payers collaborate on a variety of initiatives to drive payment reform and population health management in the market. Kaleida Health and Catholic Health of Buffalo continue to develop their respective integrated delivery networks through acquisitions and clinical expansions, putting their aligned physician groups at the forefront of payment reform in Buffalo Two health systems are opening the market’s first specialty pharmacies in 2021, a move aimed at streamlining care coordination and improving drug adherence and effectiveness Highmark’s acquisition of Blue Cross Blue Shield of Western New York could significantly impact the highly competitive payer market. Insurers offer tailored narrow network products and high-deductible plans in collaboration with health systems to appeal to employer groups looking to keep costs down. Physician groups looking to remain independent are partnering with health systems to control clinical care and protocols while remaining autonomous. Expect the new healthcare delivery landscape to be driven by the aftermath of the COVID-19 pandemic, forcing providers and payers to rethink strategic plans to accommodate new technology advancements–specifically in telehealth– and provide access to value-based care.