Which of the Following Is a Key Challenge of the U.S.health

Which of the following is a key challenge of the U.S.health care marketplace?

A) A shift away from value-based models of health care toward a performance-based system
B) Demographic changes that necessitate the need for more care availability
C) The decreasing number of Americans who use emergency rooms for primary care because they lack health insurance
D) Rising consumer expectations curtailed by greater transparency of quality