By NextBestFitPhase 3: Waves 2 & 3: working-age adults · Step 3.4
Converge provider rates
Years 1–4 · Payment Rates BoardDiscuss this step
Every concrete action this step requires, who is responsible, and when it happens relative to enactment.
| # | Action | Owner | When | Trade-off |
|---|---|---|---|---|
| 3.4.1 | Year 1: 75% prior rate / 25% UHP rate; Year 2: 50/50; Year 3: 25/75; Year 4: 100% UHP. | Rates Board | Years 1–4 | A 25%-per-year glide path reduces shocks but prolongs high payments to providers with market power. |
| 3.4.2 | Publish each hospital's and large group's revenue projection under convergence. | UHA | Year 0 | Publishing revenue projections helps planning but reveals which providers lose most. |
| 3.4.3 | Review specialty-level supply response annually; adjust the conversion factor if any specialty's wait times exceed the guarantee in 3+ regions. | Rates Board | Annual | Adjusting conversion factors for wait times protects access but weakens cost discipline. |