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

• Community Behavioral Health Did Not Comply With Requirements When Denying Prior Authorization Requests
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• 26% Of Pennsylvania General Acute Care Hospitals Posted Negative Total Margins In Fiscal Year 2025
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• Colorado Receives FDA Approval For Its Canadian Prescription Drug Importation Program
• Illinois Selects Six Organizations For $431 Billion HealthChoice Illinois Medicaid Managed Care Contracts
• Florida Blue Foundation Invests $3.5 Million To Address Florida’s Maternal Health Crisis
• Kentucky General Assembly Budget Cuts Force Lee Specialty Clinic For People With I/DD To Scale Back Outpatient Services
• CMS Consolidates Technology Functions Under New Office

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North Carolina Selects Five Regional Hub Leads For $1 Billion Rural Health Transformation Program

The North Carolina Department of Health and Human Services (NCDHHS) selected five organizations to serve as regional hub leads for the state’s Rural Health Transformation Program (RHTP). The selected organizations are Impact Health, Trillium Health Resources, Vaya Health, University of North Carolina Hospitals, and Access East. NCDHHS announced the selections on May 1, 2026, and expects to finalize the awards by June 1, 2026. The contracts are expected to run for five years. The organizations… Read

• Health Care Occupations Projected To Add 1.9 Million Annual Job Openings Through 2034
• Nonmetropolitan U.S. Communities Have 44.4% Fewer Consumer-Facing Health Care Workers Per 10,000 Residents Than Metropolitan Areas
• Tennessee to Verify Immigration Status of All Public Benefit Recipients Starting July 1
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• Median Emergency Department Visit Time Was 161 Minutes Nationwide

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