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

• Presidential Action: Eliminating Waste, Fraud & Abuse In Medicaid
• Eden Launches Free Digital Wellness Community For Metabolic Wellness, Expanding Access To Personalized Fitness & Lifestyle Support 
• Kaiser Permanente Opens New Expansion At Everett Medical Center In Washington 
• MacroHealth Acquires Foundational Pharmacy Strategies To Add Pharmacy Transparency & Choice To Its Health Care Marketplace Platform  
• Seven Corners Healthcare Invests In MobileOp4, Advancing Medical Access During Disasters & In Rural Communities 
• Corify Care Collaborates With Mayo Clinic To Improve Cardiac Arrhythmia Care Through AI 
• Balancing Margins & Growth
• 64% Of Health Care Organizations Expect Increased Value-Based Care Adoption 
• California Medicaid Reports Community Supports Cost-Effective At Reducing Avoidable Emergency Department Visits, Hospital Stays & Long-Term Care Use 
• Uber Launches Senior Accounts & Simple Mode Nationwide To Make The Uber App More Accessible For Older Adults
• Paytient Secures $40 Million From Trinity Capital To Fuel Market Expansion 
• myLaurel Secures $12 Million To Further Its Acute Care At Home Program 
• Health Care Workforce Recovery After The End Of The COVID-19 Emergency
• Home Health Agencies Offering Telehealth Use Decreased 19% Since COVID-19 Ended 
• Colorado Updates Medicaid Rules & Eases Regulations On Assisted Living Residences 

See All

Alaska To Support Practice Transformation To Integrate Primary & Behavioral Health

The Alaska Department of Health, Division of Behavioral Health (DBH) is planning to help three primary care provider organizations offer integrated mental health and addiction treatment services via the Collaborative Care Model (CoCM). The selected primary care provider organizations will be awarded grants of up to $270,000 each per year for a 4.5-year period to develop the staffing and systems needed to implement the CoCM. CoCM focuses on defined consumer populations who are tracked in… Read

• 30% Of Health Care-Related AI Pilots Reach Production 
• Colorado House Bill 25-1213: Updates To Medicaid – Concerning Changes To The Medical Assistance Program
• Virta Health Launches Cost Guarantees For Its Weight Loss & Diabetes Reversal Program, Promising 0% GLP-1 Utilization Trend & Guaranteed Weight Loss 
• Riding The Policy Rollercoaster
• Real Time Medical Systems Launches New Value-Based Care Solution, Delivering Live Post-Acute Care Insights

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