Context: The American health care system is dynamic and ever evolving. As athletic training continues to advance, our understanding of and the ability to integrate best practices in policy construction and implementation, documentation, and basic business practices is critical to promoting optimal patient care. Objective: To identify and compare knowledge gaps of clinicians and educators regarding health care delivery systems and administration. Design and Setting: Cross-sectional, Web-based survey. Patients or Other Participants: Athletic trainers (N = 485), representative of the national demographic of the profession (age = 37 ± 12 years, experience = 14 ± 11 years). Intervention(s): We used a multi-part assessment including a perceived knowledge questionnaire, validated knowledge assessment (21 items: knowledge retrieval [11 items], knowledge utilization [10 items]), and self-efficacy scales. Main Outcome Measure(s): We calculated the knowledge assessment total score and compared educators (n = 41) and clinicians (n = 444). We calculated the knowledge gap with a Spearman [rho] correlation to determine the relationship between perceived knowledge mean and the knowledge retrieval subscore. We calculated the practice gap with a Spearman [rho] correlation to determine the relationship between self-efficacy mean and the knowledge utilization subscore. Results: Athletic trainers scored less than 50% on a knowledge assessment (mean = 10.27 ± 2.41 of 21) about health care delivery systems and administration. We identified that educators scored approximately 1 point higher (11.65 ± 0.4) than clinicians (10.14 ± 0.11), equivalent to 7% to 10% higher on the knowledge assessment. We identified, relative to health care delivery systems and administration, a knowledge gap (Spearman [rho] = 0.161, P < 0.001) between perceived knowledge and knowledge retrieval and a practice gap (Spearman [rho] = 0.095, P = 0.037) between self-efficacy and knowledge utilization. Conclusions: Athletic trainers demonstrated knowledge and practice gaps related to health care delivery systems and administration. To meet the expectations of the practice analysis and the needs of patients in today's American health care system, we must engage in professional development in this domain of practice.