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

• Colorado Executive Order D 2025 014: Declaring Insufficient Revenues Available For Expenditures Due To H.R. 1 & Ordering Suspension, In Whole Or In Part, Of Certain State Programs & Services In Order To Meet A Revenue Shortfall In Fiscal Year 2025-26
• Colorado Department Of Health Care Policy & Financing 2025 Stakeholder Webinar
• $450K In Mental Health Parity Penalties Issued To UnitedHealthcare
• Premium Sticker Shock—It Depends
• Blue Cross & Blue Shield Of Illinois Provides $10 Million In Grants To Address Mental Health, Supportive Housing & Food Insecurity
• Develop Health Raises $14.3 Million To Automate Prior Authorization & Medication Access Using GenAI
• Timely & Effective Care – State
• NeueHealth Acquired By New Enterprise Associates In $1.47 Billion Deal
• Kaiser Permanente Launches In Northern Nevada In 2026 Through Joint Venture With Renown Health
• Senderra Specialty Pharmacy Introduces A Data-Driven Digital Solution, Pharma Navigator
• RxBenefits’ PBM Marketplace Expands With The Addition Of Illuminate Rx
• Superpower Launches $199 Membership To Help Democratize Concierge-Level Health Care Nationwide
• Eden Health Expands Personalized Care Platform Through Acquisition Of Contigo Compounding
• Hospitals Did Not Capture Half Of Patient Harm Events Among Medicare Beneficiaries
• 96% Of Health Care Executives Are ‘Ready’ To Use Digital Health Solutions

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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

• Hospitals Did Not Capture Half Of Patient Harm Events, Limiting Information Needed To Make Care Safer
• Citizen Health Raises $30 Million To Build AI Advocate, Ushering In A New Era Of Care
• Evolve Health Announces New Services, Expanded Footprint & Provider Organization Growth
• Visana Health Women’s Virtual Clinic Secures $24 Million In Series A Funding
• DarioHealth & OneStep Announce Plans To Integrate Smartphone-Only, Clinical-Grade Fall Risk Assessment Technology Into Dario’s Digital Health Multi-Condition Platform 

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