Fiaschetti, the Pittsburgh-based insurer's president of health markets, said the strategy here has been different than in Western Pennsylvania, where it is in the process of acquiring or partnering with several health care systems, because of the different market and dynamics.

"At this point in time in the Central Pennsylvania market, we're very focused on partnering with providers and not in discussions with acquisitions," said Matt Vogel, vice president of provider relations.

Highmark plans to work much more closely with providers here than it ever has, exchanging more data, using different incentives and more care management, including patient-centered medical homes, and with more financial integration, the two said.

But, Fiaschetti added, "Things are changing rapidly. Everybody's talking to everybody."