By NextBestFitPhase 1: Enactment & build · Step 1.3
Build the claims, payment & data systems
Months 0–18, then continuous · UHA Chief Information Officer; MACs; U.S. Digital ServiceDiscuss this step
Scale Medicare's existing fee-for-service claims infrastructure from about 1.3 billion to about 5 billion claims a year, add hospital global-budget payments, dental and vision claim types, and a national real-time eligibility check.
Legal vehicle
UHA administrative authority; procurement under the Federal Acquisition Regulation with statutory exemptions for speed.
Who does it
UHA Chief Information Officer; MACs; U.S. Digital Service
When
Months 0–18, then continuous
One-time cost
$18.0B
$18.0B one-time in the transition table. Ongoing IT operation is inside UHP administration ($96.5B a year).
In this step
Tasks
8 tasks
Costs & calculations
1 cost items, each with its calculation
Trade-offs
2 pros · 2 cons · 1 trade-offs
Risks
3 risks with mitigations
What changes in the system
2 existing laws, programs, or institutions changed
Other countries
5 comparisons
Cost items
Biggest risk for this step
Claims system failure at launch. See risks.