The pandemic has impacted the highly competitive New York City market, but the healthcare trends of strategic mergers, acquisitions, and affiliations to enhance clinical integration and strengthen negotiating power have not changed as the market moves toward value-based reimbursement models. The market’s major health systems continue to take steps to develop comprehensive, standalone integrated delivery networks that can engage in risk-based, value-based initiatives and care-coordination programs. Anticipate continued shifts in patient flow with the increased number of urgent-care centers, new ambulatory-care centers, and expansion of multispecialty practices to new locations by health systems. Both affiliated and independent physicians are an integral part of healthcare transformation through their clinical expertise and success in payment reform. Insurers must still contend with high costs and tight regulations but are answering with creative ways to retain employer groups, including plans with narrow provider networks, a new virtual insurance product for small groups, and incentives such as gym memberships and wellness perks.