Healthcare in Lexington is slowly and unsteadily consolidating around UK HealthCare, Baptist Health, and CHI Saint Joseph Health System. These systems are beginning to expand outpatient locations, which will enable them to reach more patients and contain them in their networks. Health systems, particuarly CHI Saint Joseph Health, are also beginning to form new value-based contracts, which the market has historically avoided. The market’s prominent independent physician sector will feel more pressure to align with a health system as consolidation grows. Providers are also exploring direct-care arrangements that may form the basis for future direct contracts that bypass health insurers. For now, fragmentation and competition among providers means organizations like Baptist, CHI, and Lexington Clinic are likely amenable to lower rates in exchange for favorable network position. Expect carriers to use this fact to their advantage in negotiations.