The customer is the one who is willing to pay for what the organization offers. In terms of a patient, it is the one who receives the care that is provided. Since Healthcare Affordability is customer focused and value driven, a comprehensive knowledge base of this information serves to lay the foundation for an Affordability design. For any element or business within the Healthcare Affordability enterprise, the enterprise level systems that deliver value, support value delivery, and manage the organization, serve as the overall aims for improvement within the pursuit of Affordability. The assessment of structure should contain the formal and informal dynamics within the organization. At the strategic level, top leadership and senior management set the strategy, direction, and manage the business. At the operational level, the management focuses on daily activity and overall value delivery. At the tactical level, value is produced and delivered to the customer.