Richmond’s large health systems continue to drive the healthcare industry in the market, particularly Bon Secours Mercy Health and VCU Health System. The two integrated delivery networks have continued to grow their operations through strategic partnerships, expansions, and acquisitions, including several collaborations with one another. Providers across the region have been stressed, however, with the impact of the global novel coronavirus outbreak. Several facilities have postponed elective procedures and non-urgent, in-person appointments. Telehealth services have been promoted, action that is easier for Virginians following passage of a law that mandates reimbursement for remote monitoring services. The area’s value-based care activity received a boost when Virginia Care Partners, a leading physician group, was awarded status as a Medicare Shared Savings ACO. Smaller carriers such as Oscar Health and Virginia Premier Health have introduced new plan designs to Richmond residents, creating competition for the larger national MCOs that have dominated the market.