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

• Proposed Rule: Medicare Program; Implementation Of Sections 6219, 6220, & 6224 Of The Consolidated Appropriations Act, 2026
• CMS Frequently Asked Questions (FAQs) & Enrollment Scenarios For § 422.514(h): Fully Aligned D-SNPs & Medicaid MCOs
• Code of Federal Regulations Title 42, Chapter IV, Subchapter B, Part 422, Subpart K, § 422.514: Enrollment Requirements
• 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 Launch Nationwide Gold Card Program For Qualifying Providers
• 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

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Digital Health Startups Raised $7.4 Billion In The First Half Of 2026, Up 15% Over 2025

Venture funding for digital health rose by 15% in the first half of 2026 to $7.4 billion. This was an increase of 15% over the same period in 2025, which totaled $6.4 billion. The number of investment deals was nearly the same, at 244 in the first half of 2026 compared with 245 during the same period in 2025. The size of the deals shifted toward larger investments. Mega deals, defined as financings of $100… Read

• 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

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