Phase 1: Enactment & build · Step 1.5

Define the benefit package & cost sharing

Months 0–12 · Congress (statutory categories); UHA Chief Medical Officer; HTA InstituteDiscuss this step

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Task 1.5.5 of 7

Define the nursing-home room-and-board contribution: residents keep a personal-needs allowance and contribute up to 80% of income above it.

Who does it

UHA

When

Month 6

Trade-off

Requiring room-and-board contributions keeps LTC from becoming a housing program but leaves nursing-home residents with little income.

Part of: Define the benefit package & cost sharing

Write down exactly what UHP covers, what it excludes, and what patients pay at the point of care: nothing for covered services. Out-of-pocket spending falls from $556.6B to $197.3B; what remains is for excluded items.

This step changes 14 existing laws, programs, or institutions. See the list.