Distributed Healthcare's mental model is Medicare plus Medigap, for all ages. The universal essential floor is comprehensive across categories — hospital, emergency, primary, specialty, maternity and newborn, mental health and SUD, AHQB-formulary prescriptions, preventive care at $0 cost sharing, basic dental prevention and emergency extraction, emergency vision exams, hearing screening — with cost sharing set by AHQB evidence. The regulated supplemental (standardized tiers, guaranteed issue, community-rated, AHQB-supervised) is a financial and convenience layer on the same clinical floor, and the AHQB one-way ratchet migrates supplemental benefits into the floor as unit costs fall. Payment is set centrally by AHQB.
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Universal Essential Floor
AHQB-calibrated universal essential floor, comprehensive across categories — hospital, emergency, primary, specialty, maternity, mental health + SUD, AHQB-formulary prescriptions, preventive care at $0 cost sharing, basic dental prevention, emergency vision exams, hearing screening. $0 premiums for the floor from Day 1 of enrollment; supplemental tiers are separately priced. Read component →
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Provider types and delivery mechanisms
Two independent dimensions: who delivers care (VHA, Kaiser-style integrated, Medicare-style community, private supplemental) and how care reaches Americans (in-person, telehealth, mobile, Centers of Excellence, pandemic surge, drug-traceback). Capabilities cut across all provider types. Read component →
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Regulated Supplemental Market
Medigap-like financial and convenience enhancement on the SAME clinical floor — reduced cost sharing, comprehensive adult dental, vision correction, hearing aids, private rooms, faster elective scheduling. Standardized tiers, guaranteed issue, community-rated, AHQB-supervised. Separately priced — never bundled with the payroll tax; the AHQB one-way ratchet migrates benefits into the floor over time. Read component →
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Payment design — capacity vs. fee-for-service
AHQB sets reimbursement centrally on objective indices. Capacity-based payment for rural and low-volume facilities; fee-for-service where volume sustains it. No provider-by-provider negotiation. Read component →
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Long-term care
Custodial LTC at qualifying need level included in the essential floor. Currently the largest unfunded liability for American households over 65 — floor inclusion changes household finance for a generation. Read component →
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Mental health and substance use disorder
Mental-health and SUD treatment integrated with primary care under the essential floor. Therapy, psychiatric care, medication, residential treatment — no distinct financial barriers. Read component →