According to the Polsinelli-TrBK Distress Indices Report, 20 hospitals have filed for bankruptcy since 2016. Looking ahead through 2019, medical cost trends remain stable, but extremely high as healthcare costs continue to rise. HRI projects 2019s medical cost trend to be 6 percent. This is consistent with the last five years, which have seen trends between 5.5 percent and 7 percent. By integrating preventative healthcare services, payers, patients and providers can all look forward to better results.Beginning with Obamacare, healthcare has been shifting its focus from acute to preventive care, using a 6:1 cost savings ratio model. CMS (Center of Medicare and Medicaid Service) has led this change by rolling out multiple initiatives supporting re-imbursement for preventive care. The initiatives consist of Annual Wellness Visits (AWV), Chronic Care Management (CCM), Remote Patient Monitoring (RPM), Transitional Care Management (TCM) and BHI (Behavioral Health Integration).Care collaboration among providers has been a unifying theme for these initiatives. While CMS led the shift to preventive care, private insurance payers have also offered similar initiatives.