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The U.S. health care system has many

weaknesses with the primary issue being the extremely high cost of care. Individuals have access to care in many different settings however issues with transportation, restrictions regarding eligibility for certain services and ability to pay providers for services rendered are barriers to care for many Americans (Green, 2018). As health care evolves, there is an increased need for reform in the U.S. public health policies and for advancement of proposals to improve the health of the population. In the last century, the cost of high-quality medical care has risen to extraordinary rates, resulting in out of pocket payment and self-payment for services. Even minor illness or injury can incur high costs for health care consumers and the majority of Americans do not have the ability to pay for services (Green, 2018). The ability to pay medical bills often comes from health insurance coverage, either government based or through private companies to guarantee payment for health care services. Establishing costs within the health care system for procedures can help patients, employers, insurers and government officials identify the elusive value of health care services provided (Daniels & Ritter, 2018). Cost management tools can improve cost effectiveness of care such as cost information for services being available to consumers to make informed decisions about where to seek care.

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