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

• Basata Raises $21 Million To Expand AI-Based Referral & Scheduling Platform
• Anterior Closes $40 Million To Accelerate Health Plan AI Adoption, Bringing Total Funding To $64 Million
• Photon Raises $16 Million To Expand Prescription Management Platform
• Sanford Health & North Memorial Health Agree To Merge In Minnesota
• Illinois CancerCare Partners With Canopy To Expand Consumer Access & Care Between Visits
• Ohio Launches Additional Anti-Fraud Initiative With A New Medicaid Data Intelligence Platform
• Signant Health Acquires Ametris To Create An End-To-End Electronic Clinical Trial Outcome Assessment & Digital Outcome Measures Platform
• St. Paul, Minnesota’s Diamond Lake Clinic Offering EXOMIND Brain Stimulation Device To Treat Depression & Enhance Mental Health
• CMS Could Strengthen Medicare Program Safeguards To Prevent & Detect Potentially Improper Payments For Virtual Check-In & E-Visit Services
• Pennsylvania Sues Character.AI After Chatbot Impersonates Licensed Physician
• U.S. Health Insurance Enrollment Declined By 2.3 Million Between 2024 & 2025
• Primary Care Visit Rates Among Medicare Beneficiaries Declined 10% Between 2017 & 2023
• Is Dr. Chatbot Legal?
• Medicare Advantage Organizations, Prescription Drug Plan Sponsors, & Other Interested Parties: Announcement Of Calendar Year (CY) 2027 Medicare Advantage (MA) Capitation Rates & Part C & Part D Payment Policies
• AssureCare & Pillr Health Partner On Specialty Pharmacy Management Platform

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North Carolina Selects Five Regional Hub Leads For $1 Billion Rural Health Transformation Program

The North Carolina Department of Health and Human Services (NCDHHS) selected five organizations to serve as regional hub leads for the state’s Rural Health Transformation Program (RHTP). The selected organizations are Impact Health, Trillium Health Resources, Vaya Health, University of North Carolina Hospitals, and Access East. NCDHHS announced the selections on May 1, 2026, and expects to finalize the awards by June 1, 2026. The contracts are expected to run for five years. The organizations… Read

• Commonwealth Of Pennsylvania Department Of State, State Board Of Medicine v. Character Technologies, Inc.
• CMS Launches $50 GLP-1 Medication Demonstration Program For Medicare Beneficiaries
• Nebraska DHHS Launches Financial Incentive Program For Rural Health Care Workforce
• Breaking Down Silos: How One State Achieved 98% Faster Referral Response With Integrated Data & Coordination Tools
• New Coverage Pathway To Speed Medicare Beneficiary Access To Breakthrough Medical Devices

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