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

• Health Union Launches ‘HCP Connect’ Online Professional Communities 
• Regard & Cedars-Sinai Partner To Improve Consumer Outcomes & Financial Sustainability
• BetterMe Launches Corporate Wellness Program To Boost Global Workforce Productivity
• Fact Sheet: President Donald J. Trump Announces First Deal To Bring Most-Favored-Nation Pricing To American Patients
• RE: Medicaid Managed Care Payments & Emergency Medical Condition Coverage For Aliens Ineligible For Full Medicaid Benefits
• Trump Administration Strikes Deal With Pfizer Aimed At Lowering Prescription Drug Prices
• CMS Denies Matching Funds For Managed Care Payments For Emergency Medicaid Coverage For Immigrants Ineligible For Full Benefits
• Pear Suite Secures $7.6 Million In Series A Funding To Power Community Health Workers Nationwide
• Elevate Health Technologies Partners With D2 Solutions To Enhance Prior Authorization Capabilities For Medications
• Delaware Fines UnitedHealthcare $450,000 For Mental Health Parity Penalties
• Massachusetts, Hawaii, New Hampshire, Rhode Island & District Of Columbia Have The Best Health Care System Performance In Commonwealth Fund Ranking
• NeueHealth Acquired By New Enterprise Associates In $1.47 Billion Deal
• North Carolina DHHS Launches Electronic Health Records System For State-Operated Health Facilities
• Eden Health Expands Personalized Care Platform Through Acquisition Of Contigo Compounding
• Blue Cross Blue Shield Of North Dakota To Join Cambia Health Solutions As Newest Affiliated Single-State Blue Plan

See All

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

• Elevance Health & National Association Of Community Health Centers Partnership Integrates ‘Food As Medicine’ With Primary Care
• Primary Care Physicians Reportedly Spend A Median Of 16 Minutes Per Day On EHR Tasks During PTO
• At Least 1% Of Emergency Department Visits End When A Consumer Leaves Without Being Seen
• 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

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