The changing demographics of the US population influence our healthcare. Changing demographics and health care costs comprise only a portion of the set of circumstances that the US is facing. Among the biggest challenges that healthcare executives are confronted include pacing the shift to value-based models. Current and future economic issues confronting and changing the healthcare system are healthcare leaders are putting in infrastructure and governance is practicing supporting value-based models although as they are providers, they still have a significant amount of fee that is called for service revenue. Another economic issue is responding positively to the economic dynamic of local markets.