Healthcare consolidation took a new turn this year, and in a big way. On top of deals by Anthem and Optum to acquire delivery operations, the formation of the Amazon, Berkshire Hathaway, and JP Morgan (ABJ) healthcare partnership has raised anxiety to unprecedented levels.

Margin compression was already a fact of life.  But the entry of for-profits into the mix poses the threat of a new kind of competition that will increase the pressure even more. With little hope for relief on the horizon, organizations both big and small need to develop their own roadmap to deal with margin compression.  That challenge is further complicated by the transition to value-based payment models that is advancing at a varied pace in each market. With that in mind, here are some recommendations based on over 25 years’ experience with industries in transition.