These providers have low bargaining power due to price sensitive competition to be on the list and formulary of health insurance providers (Groat, 2007) . Health insurance companies are the middlemen between providers and patients and have the ability to negotiate cost-effective yet affordable costs for providers and patients. Currently, health insurance organizations rely heavily on their vendor for their business and operational activities to differentiate themselves from their competitors. For example, over the course of a year, UHG acquired a catamaran and collaborated with Walgreens to improve its Optum RX division and pharmacy.