This is the report of the Academy for Healthcare Infrastructure's Team 5. Facilitated by Dennis Bausman, PhD, of Cornell University and underwritten by Jacobs Project Management, Team 5 looked at the nation’s healthcare spending in relation to the rest of the world. Within the U.S. healthcare industry, an evolving reimbursement structure, changing technology, funding restrictions, increasing competition and rising customer expectations combine to make improving services while lowering costs—an especially daunting task for healthcare providers.