Ochsner Health and LCMC Health are in close competition for market share in New Orleans, following LCMC’s acquisition of East Jefferson General Hospital. These systems are expanding facilities and service offerings in the market, seeking to develop competing narrow networks. Ochsner’s sizable lead in care locations and statewide reach mean that the system will likely remain the market’s most powerful IDN, even if LCMC slightly surpasses its inpatient volume in coming years. More independent physicians will likely join one of these systems as consolidation continues. However, major independent organizations like The Physicians Accountable Care Organization will persist, bolstered by partnerships with national companies, such as Aledade. Health systems will gain leverage in negotiations as they grow their provider networks, but the market’s large commercial carriers have experience forming partnerships that benefit from competition between health systems. New Orleans’ top insurer Blue Cross and Blue Shield of Louisiana has close ties with Ochsner through the narrow network, joint-venture Blue Connect plan. LCMC similarly partners with UnitedHealth Group’s NexusACO as a network for fully and self-insured employers. As health systems grow, consolidate, and form closer relationships with New Orleans’ carriers, expect value-based contracting activity to accelerate and produce new risk-bearing ACOs in the market.