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

• PAR Expands Into AI by Acquiring Assessment Assist AI
• Hopscotch Primary Care Is Delivering A New Level Of Access To The Seniors It Serves
• EHR-Based Interventions Associated With 17% Lower Risk Of 30-Day Hospital Readmission
• Most Medicare Advantage Beneficiaries Live In Highly Concentrated Markets With Few Plan Choices
• Aetna Launches New AI & Digital Tools To Improve Access & Care
• Aligned Marketplace Joins Arbital Health Platform To Expand Value-Based Care Contracting For Self-Insured Employers
• Medicare Program; Implementation of Prior Authorization for Select Services for the Wasteful and Inappropriate Services Reduction (WISeR) Model
• Employers Plan To Shift More Health Care Plan Costs To Employees For 2026 Plan Year 
• Meridian Health Plan Partners With McLaren Health Care To Expand Its Network In 35 Counties Across Michigan
• Pager Health℠ Launches AI-Powered Behavioral Health Agent To Unify & Simplify Access To Behavioral Health Support
• Estimated Average Spending On Health Care During Retirement Rose 4% Between 2024 & 2025
• Abacus & Medicus IT Merge To Launch A Financial Services & Health Care-Focused IT Managed Services Provider
• Priority Health Expands Into Wisconsin As Governing Member Of Group Health Cooperative Of Eau Claire
• Steward Health Care System LLC, et al., vs. Ralph De La Torre, Michael Callum, James Karam, Sanjay Shetty, Steward Health Care Investors LLC, et al.
• Milwaukee’s Renewed Hope Home Care To Close In November 2025

See All

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

• Henderson, Kentucky Minor Outpatient Medicine (M.O.M.) Clinic Closes
• Allina Health Closing 4 Minnesota Clinics As Of November 1, 2025
• Valley Medical Center In Washington State Closes Clinics & Restructures Workforce Due To Financial Challenges
• St. Luke’s Hospital In Des Peres Closes, Due To Financial Pressures 
• Tyler Holmes Carrollton Clinic In Mississippi To Close By September 30, 2025

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