• Managed care has evolved significantly over 30 years, bringing advances in prevention, guidelines implementation, and quality metrics, with vaccination rates rising from 50% to over 90% before the COVID-19 era. • Healthcare payment models have cycled through various iterations, from traditional capitation to modern value-based contracting, with data analytics and AI emerging as key drivers of system efficiency. • Corporate consolidation in healthcare has entered its third wave, with 75% of providers now employed by larger organizations, presenting both opportunities and challenges for patient care delivery.