By NextBestFitPhase 5: Stabilize & govern · Step 5.5
Plan capacity regionally
Annual · Regional capital 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 |
|---|---|---|---|
| State certificate-of-need laws replacedYear 5 Provider payment & regulation | About 35 states require approval for some facility investments. | Replaced by regional UHP capital planning. | One national approach vs. state control. |
| Antitrust enforcement for hospital and physician mergers amendedYear 4 Provider payment & regulation | FTC challenges some mergers because consolidation raises commercial prices. | Price effects disappear under one fee schedule; merger review refocuses on access, quality, and capacity in each region. | Consolidation no longer raises prices, so more mergers may be allowed; that can still reduce patient choice and quality competition. |