New Orleans is consolidating around Ochsner Health System and LCMC Health, edging out rival HCA Healthcare, which has not embraced the market's steady shift to value-based care. LCMC's acquisition of East Jefferson General Hospital gives it volume to rival Ochsner. Meanwhile, Ochsner is continuing its path to vertical integration with a direct contract with Walmart and participation in generic drug manufacturer CivicaRx. Blue Cross and Blue Shield of Louisiana remains the top insurer and has close ties with Ochsner through the Blue Connect plan, which has a narrow network and shared governance with the health system. Physicians and health systems are forming ACOs with commercial and government payers, including Medicaid, spearheaded by LCMC Health. That said, the COVID-19 pandemic has paused expansion and will likely make it more difficult for providers and payers to manage population health and control costs through 2021.