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As reported in the September MCCRA, many employers-especially large, self-insured firms-have shown growing interest in establishing direct relationships with hospitals and healthcare systems. For now, provider organizations typically don't have the infrastructure in place to facilitate direct contracting on a comprehensive basis (see "Employers seek relationships" below). Nevertheless, it's never too early to begin nurturing relationships with local employers and offering services outside the scope of contracted arrangements. Parkview Medical Center in Pueblo, CO, is one system that's building relationships with employers in a southwest Colorado market that encompasses 15 counties and some 350,000 people.