The document discusses the evolution of the US healthcare system towards managed care models beginning in the 1980s. Managed care aimed to control costs by managing care through tools like capitation payments to providers. This shifted care delivery towards integrated delivery networks and accountable care organizations which aim to improve quality and health outcomes through continuous quality improvement efforts. Hospitals play an important role in modernizing care delivery through these quality initiatives. Looking ahead, the literature suggests further transitioning to value-based payment models that reward providers for outcomes over volume of services will define the future US healthcare system.