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

• $1.16 Million Awarded To Mississippi State University To Support State’s Behavioral Health Workforce
• University Of Montana Awarded $1.2 Million Grant To Launch Rural Youth Behavioral Health Career Pathways
• North Carolina Launches Student Loan Repayment Program To Strengthen Mental Health, Substance Use, I/DD & TBI Workforce
• Owlet & Locus Health Partner To Seamlessly Deliver Infant Health Data Into Remote Patient Monitoring Programs
• President Trump Issues Health Care Reform Proposal
• More Than 22.8 Million ACA Health Insurance Enrollments For 2026, 1.2 Million Lower Than 2025
• APA Sues New York Insurer EmblemHealth Over Mental Health ‘Ghost Network’
• Claim Health Launches AI-Powered Revenue Infrastructure For Post-Acute Care With $4.4 Million Seed Funding
• IntelyCare Acquires CareRev To Create Comprehensive Workforce Staffing Platform For Health Systems
• Intermountain Health Finalizes Acquisition Of Steinberg Diagnostic Medical Imaging In Las Vegas
• 2026 Medicaid & CHIP Beneficiary Profile: Enrollment, Expenditures, Characteristics, Health Status & Experience
• From 2002 To 2021, Annual Out-Of-Pocket Costs Increased 125.2% For Commercially Insured People With Multiple Sclerosis
• Costs & Readmission Rates Similar For Home Hospital Care For Acute Illness In Rural Settings
• The ACA Marketplace Plunge: The Most Read OPEN MINDS Industry Resources Of 2025 
• Zarminali Pediatrics Raises $110 Million To Transform Pediatric Care

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

• Huntsville Hospital Health System To Acquire Crestwood Medical Center
• U.S. Withdraws From The World Health Organization
• Direct Relief, Baxter Foundation Announce 2025 Transformative Innovation Awards In Community Health
• Anthem Blue Cross & Blue Shield, Riverside Health Announce Multiyear Contract
• Medicare Telehealth Flexibility Expires January 30 Unless Congress Acts

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