HCA Healthcare’s influence and growth strategy protects West Palm Beach's fee-for-service tradition, and the market is in a developing stage. The provider sector is driving change toward value-based care and clinical integration. New ACO contract formation has slowed, but physician groups are successfully earning savings in existing contracts with downside risk. Clinically integrated networks, including the independent Palm Beach ACO and the Tenet-affiliated Advantage Health Network, align large bases of physicians to engage in value-based contracting with commercial payers. Market leader Tenet Florida is looking to acquire ASC provider SurgCenter. The acquisition may give Tenet an advantage because payers tend to favor ASCs over hospital-based settings due to their cost effectiveness. Expect health systems to compete for surgical patient volume across care settings in West Palm Beach. The market’s commercially insured rate is higher than the national average, and the market's health plan sector is unconsolidated.