Examine changes introduced to reform or restructure the U.S. health care delivery system.

There has been increasing pressure on the U.S. healthcare system to restructure because of rising costs and the need to sustain it, especially with an aging populace and an influx people enrolling in health insurance plans as a result of recent reforms like the Affordable Care Act. These issues have been addressed by policymakers who implemented a variety of new changes, including pay-for performance models. This encourages providers to be paid for episode or bundled service rather than the quantity. They also promote consumer engagement using technologies like telemedicine. ACOs are used to coordinate care across providers and settings over time. ACOs can expand Medicaid coverage for those with low incomes and increase competition between insurers via the ACA Marketplace exchanges.