Florida Health Market Review 2021 is a valuable resource for health care organizations trying to understand the challenges they face and to fashion strategies for the opportunities presented by health reform and dynamic local markets. First published in 1998, it is our 15th report analyzing the health care payer and provider markets in the state. The report is 50 pages of data tables, trend graphics and narrative on enrollment trends, market share and financial metrics for health plans and hospital systems. The report includes an extended analysis of the competitive strategies of Florida health insurers and hospital systems. We place the data in the context of key developments, including expansion of Medicaid and Medicare managed care, hospital and health plan consolidation and health reform. The 2021 report includes an analysis of how the COVID-19 pandemic affected health plans and hospital systems, looking at their profitability, health plan enrollment and inpatient hospital utilization in 2020 and 2021..