give an overview of the text " The changing payer-provider dynamic comes during a time of uncin summer 2021, more than 40% of health system leaders said they were unsure they would meet budget for that year. The current year is not likely to be much easier. "In 2022, health systems will continue to see pressures of workforce shortages, supply constraints and new market entrants, all of which will create pressure to maintain budget performance," Nelson said. "Those systems that have embraced creative solutions to these issues throughout the pandemic will be strongly positioned to improve performance