Phase 3: Waves 2 & 3: working-age adults · Step 3.4

Converge provider rates

Years 1–4 · Payment Rates BoardDiscuss 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
Hospital and practice billing departments amendedYears 1–4 Provider payment & regulation	Departments for coding, claims, denials, prior authorization, and patient collections across many payers.	Shrink by about half: one claim format, no patient bills for covered care, global-budget encounter reporting. Hospital billing costs avoided Physician billing costs avoided Jobs: Provider billing, coding, prior-authorization & patient-collections staff	Providers save money; billing staff lose jobs.