Universal HealthcareBy NextBestFit
Phase 3: Waves 2 & 3: working-age adults · Step 3.6

Create integrated care organizations (ICOs)

Years 2–4 · UHADiscuss this step
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Task 3.6.2 of 4

Set capitation at 97% of expected UHP spending for the enrolled population (risk-adjusted), with audits of risk coding.

Who does it
Rates Board
When
Year 2
Trade-off

A 97% capitation rate guarantees savings but may be too low for systems serving sicker patients.

Part of: Create integrated care organizations (ICOs)

Provider-run integrated systems can accept a single risk-adjusted global budget for patients who choose them. This preserves the Kaiser/Geisinger model without an insurance layer.

This step changes 3 existing laws, programs, or institutions. See the list.