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

• WellSky Joins Epic Toolbox To Improve Consumer Care Transitions and Coordination Through The Community Resource Network
• Humana Report Finds Value-Based Care Associated With 13.4% Fewer Emergency Department Visits
• Choice Health At Home Completes Acquisition Of Family Tree Private Care, Expanding Full Continuum Of Home-Based Care
• Humana’s CenterWell Completes Acquisition Of MaxHealth From Arsenal Capital Partners
• Garner Health Raises $118 Million To Close The Health Care Quality & Cost Gap; Reaches $1.35 Billion Valuation
• Alaffia Health Raises $55 Million For Its AI Platform To Reduce Administrative Health Care Waste
• Community Care Cooperative Strengthens ACO Network With 10 New FQHCs To Improve Outcomes and Reduce Costs
• NYC Health + Hospitals/Kings County Opens ACE Center For Child Abuse Evaluation & Prevention
• Senior Care & Hospital Bankruptcies Increased In 2025 While Other Health Care Sectors Declined
• The Fix For Rural
• Medicare ACOs To Serve 4.4% More Beneficiaries In 2026
• Fact Sheet: 2026 Medicare Accountable Care Organization Initiatives Participation Highlights
• Phase 1 Summary Report – Achievements, Findings & Recommendations
• Minnesota DHS/MNIT Vulnerability Assessment
• State Of Minnesota MNSite Work Order Contract

See All

Maryland Expands Advanced Primary Care To Medicare & Medicaid Members

On January 21, 2026, the Maryland Department of Health announced that the state expanded its advanced primary care delivery system to cover approximately 1.2 million residents enrolled in Medicare and Medicaid. The expansion, which took effect January 1, aims to improve preventive care and reduce unnecessary hospital visits by focusing on coordinated care and addressing social determinants of health. The state now operates three advanced primary care programs designed to give care teams more time… Read

• Minnesota DHS/MNIT: Pre-Payment Solution Roadmap & Rapid Response Team To Improve Detection Of Fraud, Waste & Abuse In DHS Health Care Programs
• Minnesota DHS/MNIT Claims Editing System Assessment
• Rural Health Transformation Program State Project Abstracts
• MotivHealth Expands Into Georgia and Wisconsin, Bringing Innovative Self-Funded Health Plan Solutions To More Employers
• Findhelp and Manifest MedEx Announce Data-Sharing Partnership To Advance Integration Of Social and Health Care Data Across California

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