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

• Medicare Part B Premiums Will Increase By $17.90 In 2026
• Medicare Updates Processing Of Telehealth Claims; Will Allow Provider Organizations To Resubmit Some FFS Telehealth Claims
• Joint Commission, Coalition For Health AI Focus On Working Toward Voluntary AI Certification
• All 50 States Seek To Transform Rural Health With CMS
• Proactive MD Expands Urgent Care Access With New Acquisitions
• Indiana FSSA Announces End Of MDwise Participation In Indiana Medicaid’s Healthy Indiana Plan & Hoosier Healthwise Programs
• UConn Health Submits Bid To Assume Responsibility For Guiding & Sustaining Waterbury Hospital
• Aristotle, Inc. Launches Aris, AI Life Coach For Every Life Stage
• Mentavi Health Announces The Launch Of Mentavi Concierge
• AMA Launches Center For Digital Health & AI
• California Legislation Limits Private Equity & Hedge Fund Influence Over Medical Decision-Making
• Kaiser Permanente & Renown Health Announce Health Plan Launch For 2026 Open Enrollment
• With 72% Of American Youth Having Used AI Companions, Safeguards Recommended
• Enforcement Alert: Information Blocking
• HHS Announces Crackdown On Health Data Blocking

See All

California To Phase Out Prior Authorization For Health Care Services With Approval Rates Of 90% Or Higher

New legislation in California, signed on October 6, 2025, directs health plans and health insurers to phase out prior authorization for health care services with approval rates of 90% or higher by January 1, 2028. The legislation is supported by the California Medical Association (CMA). The goal is to reduce the administrative burden on health care provider organizations and to reduce delays in care for consumers, according to the CMA. The legislation does not apply… Read

• Guidance On Responsible Use Of AI In Healthcare
• DocGo Acquires Virtual Care Platform SteadyMD, Expands Telehealth Services Across All 50 States
• Chaptered California Senate Bill 351: Health Facilities
• Brain-Body Therapy Debuts App Blending Therapy & Exercise To Transform Mental Wellness
• Kipu Health Collaborates With AWS To Bring Cutting-Edge Generative AI To The Behavioral Health Industry

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