Susan DeVore: 2018 was a groundbreaking year. A number of organizations placed bets on healthcare transformation, announcing a series of new deals, new offerings, and new combinations that often paired entities at different levels of the health care marketplace. These initiatives were surprising in an industry that historically pursued mergers and acquisitions via horizontal adjacencies, rather than vertical combinations. In 2019, the table has been set for new healthcare paradigms, where the bets made in 2018 start to get collected and change becomes visible in real time. We see some clear trends taking shape that should guide strategic thinking.