Joel Zinberg writes in this HealthAffairs piece:

“Are provider-led health care networks equipped to function like insurance companies? Do they have the expertise and experience to assess population health risks and costs and to accurately price health insurance products? The answer is no, and the current effort to consolidate providers and make them into ersatz insurers is a prescription for disaster.”

Later, he concludes:

“Perhaps, the ACA’s architects intended this too big to fail scenario to extract concessions from healthcare providers or prompt a government takeover of healthcare. But the clear and present danger of multiple major healthcare network failures could trigger an economic crisis. Government policies that encourage provider consolidation and risk-bearing have not delivered their promised benefits and should end before the inevitable network failures occur.”