"[E]mployers are projecting a 5 percent hike in 2019 for the total cost of providing medical and pharmacy benefits for the sixth consecutive year.... 35 percent of respondents [said] they are implementing alternative payment and delivery models such as accountable care organizations and high performance networks either directly or through their health plan.... 3 percent of respondents in 2018 said they were contracting directly with health systems and providers and that number is slated to grow to 11 percent in 2019."

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