Cincinnati continues to be dominated by IDNs that offer a wide range of high-demand specialty services and align thousands of physicians through clinically integrated networks. These IDNs are slowly turning Cincinnati into a more of a specialty care hub, with upcoming additions to oncology and cardiology service lines that will draw more patients to the market once the COVID-19 pandemic subsides. High unemployment caused by the pandemic will have a noticeable impact on the market’s payer mix, with many lives exiting the commercial market and entering Medicaid, thanks in large part to Ohio’s status as a Medicaid expansion state. A gradual economic recovery over the coming year will start to reverse this trend, as individuals return to work and gain employer-sponsored coverage. Independent and rural providers, already struggling before the pandemic, may look more to IDN acquisitions or employment as a method to survive in the market. Meanwhile, employers and providers are likely to sideline any plans they may have had to launch new alternative payment models, like direct contract bundled payments or ACOs, due to the pandemic.