By NextBestFitPhase 3: Waves 2 & 3: working-age adults · Step 3.4
Converge provider rates
Years 1–4 · Payment Rates BoardDiscuss this step
How other countries handled this same piece of implementation, what happened, and what it means for this plan.
Side by side
| Country | Approach | Result | Lesson for this plan |
|---|---|---|---|
| This plan (U.S.) | Each provider's payments move from its prior blended rate toward UHP rates by 25% a year over four years, so revenue changes are gradual. | ||
| France | Activity-based hospital payment (T2A) phased in from 10% of public hospitals’ funding in 2004 to 100% by 2008. | Gradual redistribution between hospitals without abrupt closures. | A multi-year blend of old and new payment eases the shock. |
| Germany | DRG introduction phased in hospital base rates over 2003–2009 (convergence phase). | Gradual redistribution between hospitals. | Multi-year convergence prevents hospital shocks. |
France
- What they did
- Activity-based hospital payment (T2A) phased in from 10% of public hospitals’ funding in 2004 to 100% by 2008.
- What happened
- Gradual redistribution between hospitals without abrupt closures.
- Lesson for this plan
- A multi-year blend of old and new payment eases the shock.
Germany
- What they did
- DRG introduction phased in hospital base rates over 2003–2009 (convergence phase).
- What happened
- Gradual redistribution between hospitals.
- Lesson for this plan
- Multi-year convergence prevents hospital shocks.
More precedent
- Medicare's 4-year transition to the inpatient PPS (1983–87).