By NextBestFitPhase 1: Enactment & build · Step 1.7
Set the national fee schedule
Months 3–15; annual updates thereafter · Payment Rates Board; UHADiscuss this step
Adopt Medicare's RBRVS fee schedule as the base, raise primary care to 125% of Medicare, procedural specialties to 105%, and others to 112% on average. Physician & clinical UHP spending becomes $1.05T (price effect −$21.4B, utilization effect +$113.0B).
Legal vehicle
Universal Health Act, Title V; Payment Rates Board recommendations with congressional veto.
Who does it
Payment Rates Board; UHA
When
Months 3–15; annual updates thereafter
Recurring, per year
+$91.7B
Ledger line 'Physician & clinical services': $1.11T → $1.20T.
In this step
Tasks
6 tasks
Design choice & alternatives
2 decisions with alternatives
Costs & calculations
3 cost items, each with its calculation
Trade-offs
3 pros · 2 cons · 3 trade-offs
Risks
2 risks with mitigations
What changes in the system
6 existing laws, programs, or institutions changed
Other countries
5 comparisons
Cost items
- Physician & clinical services$1.20T
- Other professional services$209.4B
- Physician billing costs avoided$72.1B
Biggest risk for this step
Physician early retirement and opt-out. See risks.
Steps that depend on this one