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

• Publicly Traded Health Care Companies Increased Shareholder Payouts By 315% Over 20 Years
• Hospital CEO Exits Decline In 2024 Compared To 2023 
• 41% Of Current Drug Shortages Started In 2022 Or Earlier 
• Three Health Care Professions Ranked Among Top 10 Best Jobs 
• Guardian Pharmacy Services Acquires Washington-Based Mercury Pharmacy Services, Expands Pacific Northwest Footprint 
• EmpiRx Health PBM Launches New Clinical Review Messaging Solution 
• CSI Pharmacy Expands Its Chronic Disease Pharmacy Care To California, Achieving Nationwide Reach 
• Prompt EMR Rebrands As Prompt Health To Reflect Expanded Vision & Platform 
• 432 Rural Hospitals At Risk Of Closing 
• Family Health Care Spending Up 188% in Employer Plans Since 2005 
• Supreme Court Narrows Medicaid Beneficiary Right To Sue  
• Molina Healthcare Of Nevada Grants Over $700,000 To Support Greater Access To Care 
• Healthy Blue Louisiana & Grace At The Greenlight Partner To Support Vulnerable Communities In New Orleans 
• Supreme Court Ruling In Medina v. Planned Parenthood South Atlantic
• Workplace & Community Violence Cost Hospitals $18 Billion Annually 

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

• HHS Cancels $766 Million Moderna Funding For Investigational Influenza Vaccines  
• Older Adults Outnumber Children In 11 States & Nearly Half Of U.S. Counties
• Announcement Of Calendar Year (CY) 2026 Medicare Advantage (MA) Capitation Rates & Part C & Part D Payment Policies
• Supreme Court Decision Protects Insurance Coverage Of Preventive Care
• Colorado Updates Medicaid Rules

To sign-up for monthly Health Care System alerts, you must be signed in to your account.