Provision of health care is rapidly evolving in an era of cost consciousness and new treatments, making the evaluation of technology and its adoption important and necessary. Many of these rapidly shifting market conditions were precipitated by hospital mergers in light of incentives in the Affordable Care Act.1 The study by Wright et al2 in this issue of JAMA Surgery associates more competitive regional markets with a higher likelihood of patients undergoing a robotic-assisted procedure, but among hospitals that acquire a robot, more competition was not related to the use of robotic-assisted surgery.