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.

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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

• Committee On Energy & Commerce Letter To Washington Requesting Information Related To Medicaid Fraud
• Committee On Energy & Commerce Letter To Vermont Requesting Information Related To Medicaid Fraud
• Committee On Energy & Commerce Letter To Pennsylvania Requesting Information Related To Medicaid Fraud
• Committee On Energy & Commerce Letter To Oregon Requesting Information Related To Medicaid Fraud
• Committee On Energy & Commerce Letter To New York Requesting Information Related To Medicaid Fraud

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