As the largest third-party payer in the United States CMS (Centers for Medicare and Medicaid Services) has a broad often unspoken influence over many aspects of a health care organizations decisions and daily activities. In addition there are external forces that affect the operations of health care organizations such as accreditors managed care organizations and so on.Remember that this work is to be your own thoughts based on what you know and have learned. You should create a submission that demonstrates your thought and understanding lightly supported by at least 1 resource from the library. As indicated in the grading rubric (under the Student Expectations button) your ability to think about the material and synthesize the concepts and articulate current or future processes and issues is what is to be graded.