Consolidations in the health and human service field is at every level. The five largest (by direct premiums)  health insuring organizations have 45% of the U.S. market according to the Market Share of Leading U.S. Health Insurance Companies 2020, By Direct Premiums. The ten largest health systems now control 24% of their market (see The Potential For Rapid Consolidation Of Health Systems). And the health plans and provider systems are merging into even more powerful 'payvider' organizations (See The 'Payviders' Are Coming—From Both Directions).

So far this year, there have also been 6,000 mergers in the . . .

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