With small hospital and expansion projects coming online during the pandemic, Indianapolis health systems will begin looking long-term now that Indiana University Health has begun its massive downtown consolidation of adult services. The market will remain in tight competition for patient volume and market share with the top four systems bunched together. While Indianapolis still has small independent practices, mostly single-specialty, OptumCare’s American Health Network could be the source of innovation centered around UnitedHealthcare members. It will be difficult for any insurers to make major dents in Anthem’s dominant share in Indianapolis, its home market. The migration to telehealth spurred by COVID-19 will have long-lasting impact with the Indiana Legislature loosening restrictions, and health systems, physicians, and patients embracing the shift. It is likely that the Indianapolis healthcare market will see more moves from small specialty practices to partner with health systems to boost top specialties.