Orlando’s reliance on tourism may slow down the market’s financial recovery from COVID-19. Employers may look to consumer-driven health plans to control costs. People who lost their employment may also turn to the health insurance exchange, which could bode well for exchange participants Florida Blue, Oscar Health, Centene and newcomer Cigna. Payers have the ability to offer a narrow network plan that controls costs while also featuring a health system, like AdventHealth or Orlando Health, that appeals to locals.While it is hard to overstate the influence of the health system sector in Orlando, payers have found ways to exert control over care delivery and are invested in blurring the line between payer and provider as much as health systems are. UnitedHealthcare, Florida Blue, and Humana operate clinics in the market. Payers use primary-care providers as gatekeepers for other forms of care and steer beneficiaries to in-network providers. The tighter control payers exert over physician groups may be one way payers hit back at direct contracting agreements between IDNs and Disney.