The rapidly growing Dallas market is seeing a surge of expansions around specialty care and Texas' first and only Sarah Cannon Cancer Hospital. The value of outcomes-based contracting is growing more apparent in Dallas, where Baylor Scott & White and Texas Health Resources operate top-ranking ACOs, and Genesis Physicians Group recently launched the market’s first Medicaid ACO. Tensions between payers and providers are rising in Dallas, which now has two insurer-operated clinic chains—Blue Cross and Blue Shield of Texas’ walk-in clinics with Sanitas, and CVS HealthHUBs—that allow the insurers direct control over care and drug delivery. While the post-pandemic future is uncertain, Dallas lies at the heart of the nation’s uninsured and provider shortage crises, and innovation to address social determinants of health and medication adherence for the market’s large chronically ill population is not only likely but imperative. Prescription drugs that can help treat these diseases will continue to be in high demand.