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

• Revenue Over Volume
• Harbor Health Raises $130 Million To Expand Insurance Plans, Clinical Footprint, Specialty Services & Care Access
• New Mexico Pledges To Backfill 100% Of Lost Federal ACA Subsidies
• In 2024, The U.S. Death Rate Dropped To Levels Seen In 2020
• Harbor Health To Acquire 32 VillageMD Health Clinics & Expand Into Three New Texas Markets
• 340B Drug Spending Rose From $6.6 Billion In 2010 To $43.9 Billion In 2021
• Mortality In The United States: Provisional Data, 2024
• Diana Health Raises $55.4 Million For Mental Health, Integrated Health Offering For Women
• Pediatrica Health Group Acquires Capote Pediatrics
• Talkspace & Tia Health Team To Address Women’s Mental Health Needs At All Stages Of Life
• Ensfotek’s DrCloudEHR Announces Launch Of AI-Powered Group Scribing, For Behavioral Health EHRs
• Regional Health Properties & SunLink Health Systems Announce Receipt Of Shareholder Approvals For Merger
• CVS Health Subsidiary Omnicare Initiates Voluntary Chapter 11 Process
• Charlotte-Area Carolina Neurosurgery & Spine Associates Facility Locations To Join Atrium Health
• Bespoke Concierge MD Launches Corporate Health Plans, Redefining Employee Wellness & Preventive Care

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Federal Budget Bill Brings Major Administrative & Financing Changes To Medicaid, ACA Marketplace & Medicare 

On July 4, 2025, President Trump signed the 2025 federal budget reconciliation package called the One Big Beautiful Bill (OBBB) Act, which enacts significant administrative and financing changes to health care policy affecting Medicaid, Medicaid expansion plans, Affordable Care Act (ACA) Healthcare Marketplace plans, and Medicare. An early analysis by the Congressional Budget Office (CBO) projected that the overall number of uninsured people will increase and health insurance premiums will likely increase as a result.   Medicaid … Read

• Growth In The 340B Drug Pricing Program
• Bayvrio Launches First-Of-Its-Kind Marketplace That Provides Health Care Payers With Greater Choice, Flexibility & Control
• CMS Extends AHEAD Model Through 2035 With New Requirements For States
• Illinois Issues New Procurement For Medicaid HealthChoice Illinois Managed Care Contracts
• Medicare Shared Savings Program Accountable Care Organizations Performance Year 2024 Financial & Quality Results

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