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

• Innovation Adoption Among Specialty Care & Primary Care Provider Organizations: The Results Of The 2025 OPEN MINDS Innovation Adoption Survey
• Los Robles Regional Medical Center Shutters Children’s Unit 
• Montana Prepares Section 1115 Waiver To Implement Work Requirements, Cost-Sharing 
• Choose Medicare Act
• Otsuka Partners With Japanese Researchers On Epilepsy Treatment Support System With eMind Smartphone App 
• Virginia Medicaid Launches Cardinal Care Health Plans & Member Options 
• UCI Health―Irvine To Be The Nation’s First All-Electric Acute Care Hospital 
• Samsung Acquires U.S. Health Care Data Integration Company Xealth 
• The 2025 Federal Budget Reconciliation Bill (H.R.1 – One Big Beautiful Bill Act): Implications For The Health & Human Service Field
• Federal Budget Bill Brings Major Administrative & Financing Changes To Medicaid, ACA Marketplace & Medicare 
• OBBB Myth vs Fact
• Estimated Effects On The Number Of Uninsured People In 2034 Resulting From Policies Incorporated Within CBO’s Baseline Projections & H.R. 1, The One Big Beautiful Bill Act
• The 2025 Federal Budget Reconciliation Bill (H.R.1 – One Big Beautiful Bill Act)
• The Mindful Lemon Selects Qualifacts To Support Rapid Expansion & Enhance Client Care 
• Humana’s CenterWell Business Agrees To Acquire The Villages Health In Florida 

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Federal Budget Bill Brings Major Administrative & Financing Changes To Medicaid, ACA Marketplace & Medicare 

On July 4, 2025, President Trump signed the 2025 federal budget reconciliation package called the One Big Beautiful Bill (OBBB) Act, which enacts significant administrative and financing changes to health care policy affecting Medicaid, Medicaid expansion plans, Affordable Care Act (ACA) Healthcare Marketplace plans, and Medicare. An early analysis by the Congressional Budget Office (CBO) projected that the overall number of uninsured people will increase and health insurance premiums will likely increase as a result.   Medicaid … Read

• Cherokee Health Systems Rebrands As River Valley Health 
• BlueCross BlueShield Of Tennessee Winding Down Shared Health Subsidiary, With Dual Eligible Plans In Mississippi & Texas 
• Joint Commission Launches Simplified Accreditation Standard With Fewer Requirements 
• CMS Rescinds EMTALA Guidance On Emergency Abortions 
• 61% Of Nurses Plan To Make A Job Change Within One Year 

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