The $2.8 trillion US health industry is in the midst of significant disruptive transformation. The full deployment of the Affordable Care Act, and related upheaval in the regulatory landscape; an industry-wide shift to consumerism; consolidation among providers, pharmaceuticals, and insurers; and emerging incubator industries such as electronic records management, and customized healthcare technology (HIT) development is creating both uncertainty and opportunity for strategically positioned companies. Taken together, these factors have begun to define a new health economy, focused on flexibility, technology leverage, and customer “stickiness”. In the short-term this may create a sink-or-swim dynamic, and success will largely be accomplished through focus on patient experience, effective cost management, and smart capital outlay. The shift may portend increased vertical integration, expanding patient choice including price transparency and retail delivery, and more efficient use of technology such as big data and sophisticated analytics to identify and predict patient preference and clinical outcomes.