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.
Editor’s Picks
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Medicare Ends Part D Premium Subsidy Program
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Delaware Enacts Moratorium On For-Profit Acquisition Or Control Of Non-Profit Acute Care Hospitals
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Kentucky Governor Reverses Planned 4% Medicaid Rate Cut Using $255 Million In State Surplus
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Health Care Professionals Report Increased Trust In Payers & Digital Tool Benefits
Latest Resources
- Required Standardization Of ACA Marketplace Health Plans To End In 2027
- Pennsylvania Medicaid Seeking Input On I/DD Managed Care & Physical/Behavioral Data Sharing
- 64% Of Parents Financially Supporting Adult Children Report Financial Stress
- CMS Medicaid Fraud Initiative Targets 50 Provider Organizations In First Three Months
- CMS Receives New Authority To Exclude Provider Organizations From Federal Health Care Programs
- Centene To Waive Prior Authorization For Select Outpatient Services Starting November 2026
- Suicide Becomes The 10th Leading Cause Of Death In The U.S.
- The Measure Of Success
- TidalHealth Primary Care Facility In Federalsburg, Maryland To Close In November 2026
- Harris County, Texas Health Leaders Create Harris Collaborative To Transform Care For The Region’s Most Vulnerable Residents
- Hope Charities Receives Favorable OIG Advisory Opinion To Expand Consumer Assistance Program For Federal Beneficiaries
- Mississippi Receives $104 Million To Transform Rural Health Care Through Cutting-Edge Technology & Expanded Care Closer To Home
- Sixty Years Later…
- Connecticut Awarded $50 Million To Optimize Care Delivery & Improve Rural Hospital Infrastructure
- What’s Keeping You Up At Night?
- Crushing Fraud 2026: CMS Facts & Figures, January 1, 2026 – June 30, 2026
- Final Rule: Statement Of Delegation Of Authority
- Remedy Specialty Network Launches, Uniting Four Core Business Units Under One Integrated Brand
- Rise Adolescent Treatment Center Opens In Las Vegas To Serve Youth Ages 12-17
- Ascension To Sell Its Stake In Arizona’s Mercy Care To Aetna
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Government Contract Bidding Opportunities
- Massachusetts Seeks Enrollment & Marketing Support Services
- California’s Yuba County Seeks Consulting Services For CalWORKs Outcomes & Accountability Review (CalOAR) Continuous Quality Improvement (CQI) Project
- Pennsylvania’s City Of Philadelphia Seeks Injury Prevention Program Services
- Federal Government Announces NLM Institutional Grants For Research Training In Biomedical Informatics, Data Science & AI (T15 Independent Clinical Trial Not Allowed) Funding
Government Contract Award Announcements
- Texas’ Kendall County Awards Inmate Health Care Services Contract To Southern Health Partners, Inc.
- Alaska Awards Mental Health Trust Authority Home & Community-Based Services Innovation & Reform Contract To HCBS Strategies, Inc.
- Virginia Awards Mobile Crisis Response Training Services Contract To Sargad, LLC
- Nebraska Awards Tobacco Quitline Services Contract To Consumer Wellness Solutions, Inc.
- Ohio’s Lucas County Awards Comprehensive Health Care Services For Incarcerated Individuals Contract To Armor Health Of Lucas County, LLC
