The changes in healthcare are occurring on many fronts and with increasing speed. The simple driver is that utilization is up due to population growth, a higher percentage of covered lives and an aging society. Consistent with this, costs are up due to the growing number of patients, the sophistication of the treatments and the rising costs of technology and prescriptions. The US healthcare per capita spend in 2000 was $4,857. By 2014, it was $9,523; that’s a growth rate of 5.3% per year. For the US, this amounts to over $3 trillion per year or 17% of Gross Domestic Product. As a result, the overall system is resource constrained and economically stressed, which is leading to more stringent upfront testing, the requirement for better outcomes, and the utilization of alternative lower cost treatment venues.