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State Health Plan Proposed Changes Threaten Healthcare Access for All

Raleigh NC – November 28, 2018 – Healthcare leaders across the state say the impact of proposed changes to the State Health Plan will limit choices for all North Carolinians, including state employees, teachers and their families in need of healthcare services. A new pricing scheme being promoted by the State Treasurer will reduce support to physicians and hospitals to achieve savings, but could force hundreds of providers out of the State Health Plan network or out of business. More concerning is that this proposal does irreparable damage to the state’s healthcare safety net.

“We believe the treasurer is not being transparent about what this proposal will do to state health plan members and their families,” said Steve Lawler, president of the North Carolina Healthcare Association (NCHA). “He is busy making promises about premiums, but neglecting to address specifics about the provider network and access issues, and the fact that it does nothing to help individuals and families meet their healthcare objectives.”

NCHA estimates the losses to hospitals and health systems alone will be upwards of $400 million and could be especially damaging to rural and community hospitals already struggling with high numbers of uninsured and Medicaid patients.

“We have a large number of state employees in Burke County who rely on our services and we’re concerned this plan will give them less options,” said Kathy Bailey, president and CEO of Carolinas HealthCare System Blue Ridge in Morganton. “In the everchanging healthcare landscape, sustaining the quality and availability of healthcare provided to this community is our number one goal. “

The State Treasurer has refused attempts by healthcare providers to discuss value based care, though his own professional staff has recommended it as a viable path forward for the State Health Plan. In an article in the North Carolina Medical Journal, executive director Dee Jones pointed to case management, outcomes-based payment models and member education as ways to manage costs. Yet the proposal includes none of those strategies.

“As a self-insured health plan, we have seen tremendous value in engaging our employees in managing their health,” said Chuck Mantooth, president and CEO of Appalachian Regional Healthcare System. “Not only have we decreased costs, we have also helped employees improve their health. Our community includes thousands of state employees who deserve the same opportunities. To exclude value based care from the discussion is short sighted and irresponsible.”

The far-reaching implications of changes to the State Health Plan warrant more thorough study and evaluation. North Carolina’s healthcare providers stand ready to help build a smarter health plan that puts health first and ensures a stronger future for the state.

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NCHA is a trade association representing more than 130 hospitals and health systems providing acute care, rehabilitative, behavioral, psychiatric and veterans’ services. The association promotes improved delivery of quality and affordable health care in North Carolina through leadership, advocacy, information, and education in its members’ interest and for public benefit.

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