By NextBestFitPhase 1: Enactment & build · Step 1.8
Set hospital global budgets
Months 6–18; annual negotiation thereafter · UHA regional offices; Payment Rates BoardDiscuss this step
Each hospital gets an annual operating budget covering all UHP patients, negotiated with its regional office. In aggregate, hospital spending goes from $1.63T to $1.62T (price effect −$69.9B, utilization +$51.5B).
Legal vehicle
Universal Health Act, Title V; Maryland Total Cost of Care methodology as a template.
Who does it
UHA regional offices; Payment Rates Board
When
Months 6–18; annual negotiation thereafter
Recurring, per year
−$18.4B
Ledger line 'Hospital care': $1.63T → $1.62T. The capital spending line (structures & equipment) stays at $168.2B.
In this step
Tasks
7 tasks
Design choice & alternatives
2 decisions with alternatives
Costs & calculations
2 cost items, each with its calculation
Trade-offs
3 pros · 3 cons · 2 trade-offs
Risks
3 risks with mitigations
What changes in the system
7 existing laws, programs, or institutions changed
Other countries
6 comparisons
Cost items
Biggest risk for this step
Hospital closures in commercially dependent markets. See risks.
Depends on