Southern Connecticut is an innovative healthcare market with a high level of health system consolidation, physician clinical integration, and vast experience in value-based care initiatives and payment reform. Yale New Haven Health continues to dominate the health system sector but look for new competition from Nuvance Health and YNHH rival Hartford HealthCare now firmly in the market. Physician groups and accountable care organizations are heavily involved in payment reform and are preparing to take on risk. Insurers continue pushing high-deductible products with narrow networks to manage costs and promote the use of generic drugs, but the introduction of a new virtual plan, a completed merger between two nonprofit insurers, and Cigna reentering the small-group market will shake up the long-time status quo Anthem Blue Cross Blue Shield of Connecticut has led for years. Connecticut has implemented a new primary care spending target initiative and introduced a bundled payment health plan for state employees since Gov. Ned Lamont signed two executive orders to establish statewide healthcare cost and quality benchmarks. Expect the market’s leaders to use their vast experience to develop new delivery systems through telemedicine and use innovation and payment reform to prepare for future health crises.