In a Businessweek article, Peter Waldman examines the impact of the purchasing power of Sutter Health, one of Northern California’s largest hospital networks. He finds that Sutter Health hospitals charge 40-70% more for typical procedures and that it requires insurers to keep those rates a secret. As the nation begins implementing health system reform, every state health reform implementation board needs to be cognizant of this issue and its effect on the market, patients, providers and insurers.