Health Care System

The United States health care system encompasses a mixture of private and public entities that are either non-profit or for-profit. Health care coverage may be financed through federal and state government programs or can be purchased through the health insurance marketplace. In contrast, a smaller proportion of the U.S. population is uninsured. The resulting effects of a decentralized system has led to considerable challenges for provider organizations—including cost pressures, a push towards alternative payment models, and market consolidation. Despite these challenges, there are opportunities for provider organizations in reducing excess costs and utilization, particularly as payers look for innovative approaches that can demonstrate a return-on-investment in terms of cost and consumer outcomes.

Latest Resources

• PCORI Funds $150 Million In New Clinical Effectiveness Research  
• Feds Release Draft Strategic Plan For Electronic Health Information, Focused On Health Equity & AI  
• Molina Healthcare Protests Florida Medicaid Decision, Plans Legal Challenge in Virginia   
• Federal Agencies Launch Portal For Reporting Anticompetitive Health Care Practices 
• Wellcare & Wellvana Partner On Primary Care For MA Members In Georgia, Tennessee & Texas  
• CVS Acquires Medicare Advantage Broker Hella Health  
• Personal Health Care Spending Increased By 19% From 2018 To 2023, Exceeding $6,700 In 2022
• Novant Health Launches ‘Hospital At Home’ Program
• CMS Finalizes First Medicaid Managed Care Maximum Appointment Wait Times For Primary Care & Behavioral Health
• Allegiance Health Management, Inc. v. MultiPlan, Inc. et al
• Medicaid Program: Medicaid & Children’s Health Insurance Program Managed Care Access, Finance, & Quality
• Texas Medicaid Releases STAR Kids RFP
• Allegiance Health Antitrust Suit Claims Out-Of-Network Algorithm Collusion
• Brightli & Places For People Partner To Expand Behavioral Health In Missouri   
• Alabama’s Huntsville Hospital System Launches Mobile Medical Unit   

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FDA Offers Guidance On AI In Health Care & Medical Product Development

Huntsville Hospital in Alabama debuted a new mobile medical unit in April. The Huntsville Hospital Foundation said the unit includes a truck and a 25-foot trailer custom-built for medical capabilities.   According to the foundation, the unit is expected to make routine stops at Huntsville-area senior centers, homeless shelters, non-profits, and community events. The unit will offer basic and preventive health care and can serve as a “medical home” for consumers.   All services offered… Read

• Colorado Seeks Accountable Care Collaborative Phase III Services
• Rapid Social Care Delivery System Evolution: The Partners In Care Foundation Case Study
• Aledade Acquires Medical Advantage To Expand Value-Based Care In Michigan   
• New Jersey’s Atlantic County Seeks Medical Care Services
• Wheel To Power New Virtual Health & Prescription Service From Owlet