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

• Personal Health Care Spending Increased By 19% From 2018 To 2023, Exceeding $6,700 In 2022
• Novant Health Launches ‘Hospital At Home’ Program
• CMS Finalizes First Medicaid Managed Care Maximum Appointment Wait Times For Primary Care & Behavioral Health
• Molina Healthcare Protests Florida Medicaid Decision, Plans Legal Challenge in Virginia   
• Allegiance Health Management, Inc. v. MultiPlan, Inc. et al
• Medicaid Program: Medicaid & Children’s Health Insurance Program Managed Care Access, Finance, & Quality
• Texas Medicaid Releases STAR Kids RFP
• Allegiance Health Antitrust Suit Claims Out-Of-Network Algorithm Collusion
• Wellcare & Wellvana Partner On Primary Care For MA Members In Georgia, Tennessee & Texas  
• Brightli & Places For People Partner To Expand Behavioral Health In Missouri   
• Alabama’s Huntsville Hospital System Launches Mobile Medical Unit   
• Colorado Seeks Accountable Care Collaborative Phase III Services
• Rapid Social Care Delivery System Evolution: The Partners In Care Foundation Case Study
• PCORI Funds $150 Million In New Clinical Effectiveness Research  
• Aledade Acquires Medical Advantage To Expand Value-Based Care In Michigan   

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FDA Offers Guidance On AI In Health Care & Medical Product Development

Physician-led value-based care operator Aledade acquired Michigan-based Medical Advantage. Medical Advantage has operated as a subsidiary of The Doctors Company, the nation’s largest physician-owned medical malpractice insurer, since 2014. Financial terms of the deal were not disclosed.  Medical Advantage offers physicians technology, tools, best practices and in-practice support. The support also includes quality performance, risk adjustment, cost management services, information technology, and analytics.   Aledade said the acquisition expands Michigan physician partnerships with Aledade from… Read

• PCORI Funds $150 Million In New Clinical Effectiveness Research  
• New Jersey’s Atlantic County Seeks Medical Care Services
• Wheel To Power New Virtual Health & Prescription Service From Owlet  
• The Hartford – Winning Contract For Short-Term & Long-Term Disability Program Services To Delaware State Employee Benefits Committee, 2024
• New York Seeks Medicaid Redesign Team Health Homes Supportive Housing Program Services