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

• Making Those AI Decisions Work
• Montana To Receive $3.63 Million In Federal Funding To Expand Rural EMS & Bring More Care Directly To Consumers Across The State
• Emplify Health & Pearl Health Partner To Expand Accountable Care Across The Upper Midwest
• Health Foundation of South Florida Invests $225,000 To Establish Overtown Youth Center As A Community Health Access Hub
• West Tennessee Healthcare Expands Critical Care Support Through EICU Program In Partnership With Philips & Hellocare.ai
• Where Are You On The AI Map? 
• Rural Health Care Organization In Indiana, Parkview Health, To Acquire Shared Services Provider Ovation Healthcare
• Otter Health Launches With $8 Million To Build A New Era Of Utilization & Quality Management Beyond Prior Authorization
• New Mexico Awarded $74 Million In Federal Funding To Expand Rural Specialty, Maternal & Behavioral Health Care
• Rutgers & RWJBarnabas Health To Launch Innovation Hub, Powered By Amazon Web Services
• Ochsner Health Partners With Joy 101 To Strengthen Workforce Well-Being & Culture
• Proposed Rule: Medicare Program; Implementation Of Sections 6219, 6220, & 6224 Of The Consolidated Appropriations Act, 2026
• CMS Frequently Asked Questions (FAQs) & Enrollment Scenarios For § 422.514(h): Fully Aligned D-SNPs & Medicaid MCOs
• Code of Federal Regulations Title 42, Chapter IV, Subchapter B, Part 422, Subpart K, § 422.514: Enrollment Requirements
• Required Standardization Of ACA Marketplace Health Plans To End In 2027

See All

Digital Health Startups Raised $7.4 Billion In The First Half Of 2026, Up 15% Over 2025

Venture funding for digital health rose by 15% in the first half of 2026 to $7.4 billion. This was an increase of 15% over the same period in 2025, which totaled $6.4 billion. The number of investment deals was nearly the same, at 244 in the first half of 2026 compared with 245 during the same period in 2025. The size of the deals shifted toward larger investments. Mega deals, defined as financings of $100… Read

• Pennsylvania Medicaid Seeking Input On I/DD Managed Care & Physical/Behavioral Data Sharing
• 64% Of Parents Financially Supporting Adult Children Report Financial Stress
• CMS Medicaid Fraud Initiative Targets 50 Provider Organizations In First Three Months
• CMS Receives New Authority To Exclude Provider Organizations From Federal Health Care Programs
• Centene To Launch Nationwide Gold Card Program For Qualifying Providers

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