Universal HealthcareBy NextBestFit
Phase 1: Enactment & build · Step 1.8

Set hospital global budgets

Months 6–18; annual negotiation thereafter · UHA regional offices; Payment Rates BoardDiscuss this step
marketlikelihood: mediumimpact: medium

Hospital closures in commercially dependent markets

Systems that relied on commercial margins can't adjust, even with the transition fund.

Early warning signs
  • Days cash on hand
  • Bond rating downgrades
Mitigation
  • Transition fund
  • Essential-facility designation
  • Regional capital boards

Implementation risks

RiskMitigation
Hospital closures in markets where commercial revenue subsidized losses.Hospital Transition Fund; closure reviews; regional boards can designate 'essential' facilities with protected budgets.
Rationing to stay within budget.Volume corridors and wait-time guarantee penalties paid by the hospital, not the patient.