Lansing belongs to its top integrated delivery networks, Sparrow Health System and McLaren Health Care, which are expanding and consolidating to cement their market positions. Physicians have historically held significant influence in the market, even when affiliating with health systems, but continued growth and clinical integration by Sparrow and McLaren has the potential to reduce physician influence in coming years. However, the presence of the multistate Consortium of Independent Physician Associations will continue to provide an alternative for physicians looking to gain the benefits of integration without sacrificing autonomy to a health system. As Sparrow and McLaren expand, they will likely be better able to coordinate care and may pursue more innovative payment arrangements. However, these systems thus far seem to prefer traditional arrangements, avoiding Blue Cross Blue Shield of Michigan’s new Blueprint for Affordability model in favor of upside-only risk-sharing. Both Sparrow and McLaren offer their own health plans, and will likely carve out niches to stay competitive with statewide juggernaut BCBS.