Security analysts took a hard look at the latest trends in the health care industry at the third annual Health System Change Wall Street roundtable held earlier this year. The roundtable focused on costs and premiums, evolving financial relationships among industry leaders, industry consolidation and pharmaceutical and technology development. The analysts' conclusions: some market strategies--including vertical integration, provider risk-sharing and equity arrangements and the use of formularies to rein in drug costs--haven't worked out as expected. Health plans and provider organizations have yet to find a magic bullet for controlling costs while responding to purchasers' and consumers' demands for broader choice. This Issue Brief reports on the trends discussed at the roundtable.