Unlike many communities, Indianapolis has emerged relatively unscathed from the nation’s economic downturn, with above-average population growth and lower-than-average unemployment and uninsurance rates in recent years. As a result, the area’s health care safety net remains relatively stable, with several strong, multi-site organizations serving low-income and uninsured patients, including Wishard Health Services. However, both providers and payers face challenges in Indianapolis. Rising health care costs have area employers interested in consumer-driven health plans (CDHPs)—high-deductible plans tied to a tax-advantaged savings account. In fact, CDHPs are growing faster in Indianapolis than in many other markets around the country. On the provider front, competition for well-insured, suburban patients continues to spur “suburbanization” of hospitals and outpatient facilities, as well as greater hospital-physician alignment.