Sign up providers & set participation rules

Months 6–18 · UHA Provider Enrollment; state licensing boardsDiscuss this step

Every existing law, program, institution, or practice this step changes: what it is today, what happens to it, when, and what that costs or trades off.

What	Today	Change	Trade-off
No Surprises Act & independent dispute resolution amendedYear 4 Federal insurance & health law	Limits surprise out-of-network bills; arbitration between insurers and providers.	Becomes largely moot (no networks, no balance billing); retained for supplementary insurance and visitors.	Ends an arbitration industry that has produced high awards.
Private-equity and investor ownership of practices and facilities amendedYear 1 Private sector	Growing PE ownership in anesthesiology, dermatology, emergency medicine, nursing homes; strategies often depend on commercial pricing and out-of-network billing.	Ownership disclosure required; out-of-network and commercial-arbitrage strategies end.	Less extraction; investor exits may destabilize some practices.
Provider networks endsBy wave Patients	Plans limit which providers are covered; out-of-network costs.	Abolished: every participating provider is in network for everyone.	More choice of provider; no plan choice.
Direct primary care & concierge medicine amendedYear 1 Private sector	Monthly membership practices, often outside insurance.	Permitted only for opted-out physicians; memberships cannot be bought with insurance. Participating practices may offer UHP primary-care capitation instead.	Keeps one queue; preserves a cash option that creates a de facto tier for those who can pay.
ACA ban on new physician-owned hospitals continues— Provider payment & regulation	Section 6001 bars new physician-owned hospitals from Medicare.	Retained under UHP to limit self-referral, subject to review by the Rates Board.	Limits self-referral; blocks a potential source of new surgical capacity.
Provider–insurer contracts and value-based agreements replacedBy wave Private sector	Each provider holds dozens of payer contracts with different rates and rules.	Terminated by statute at each wave; one UHP participation agreement replaces them.	Ends contracting overhead; ends negotiated deals some providers valued.
Licensed mental health counselors and marriage & family therapists expandedYear 1 Provider payment & regulation	Medicare began paying them only in 2024; Medicaid and private coverage vary.	Full UHP providers, paid from the fee schedule.	Adds behavioral-health capacity quickly; varying state licensure standards affect quality.
Non-discrimination by participating providers expandedYear 1 Federal insurance & health law	ACA Section 1557 and civil rights law apply unevenly; providers can refuse patients by insurance type.	Participating providers may not refuse patients on the basis of coverage source, income, health status, disability, or immigration status, and capacity limits must apply equally to all.	Ends insurance-based patient selection; providers lose discretion over their patient mix.