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

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Task 1.8.2 of 7

Compute a base budget: Medicare-equivalent volume × 1.20, adjusted for case mix, teaching status, safety-net share, and rural isolation.

Who does it

Rates Board

When

Month 9–12

Trade-off

Adjusting for case mix and teaching status is fairer but creates incentives to code patients as sicker.

Part of: Set hospital global budgets

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).

This step changes 7 existing laws, programs, or institutions. See the list.