Description: Healthcare in the United States is commonly described as a "system," but it is more accurately understood as an entangled ecosystem comprising stakeholders with different objectives, incentives, and sources of authority. This fragmentation contributes to persistent failures in access, affordability, coordination, patient experience, reliability, and financial sustainability while creating opportunities for disruption. Using a healthcare value chain framework, students examine how incumbent organizations and new entrants respond to internal and external pressures reshaping the industry. Through real-world cases, contemporary readings, and structured classroom exercises, students learn how organizations transform healthcare delivery, financing, organizational structures, and decision rights through new business and care delivery models that create, capture, or extract value. Students leave the course with a practical framework for understanding and leading disruptive change in healthcare.