The U.S. healthcare system is currently undergoing what will ultimately be a radical transformation, driven by unsustainable cost increases, increasing regulation, and shifting power relationships among payers, providers, physicians, and patients.  Technology advances are accelerating the pace of innovation, while rising costs and demands for affordable healthcare and greater transparency are challenging the economics and traditional business assumptions of the industry.

At the same time, health policy shifts brought about by the Patient Protection and Affordable Care Act (PPACA) are placing increased accountability and cost pressures on providers to improve patient safety, quality of care, and consistency of care delivered.  In response, payers (government and private) are actively engaged in changing the way physicians and hospitals are paid.  These changes include greater emphasis by payers and other stakeholders to require value for payment (e.g. pay for performance, bundled payment initiatives).