(The Center Square) – Nearly 750,000 teachers, state employees, retirees, lawmakers active and retired, and members of higher education on Jan. 1 will have a new healthcare access through the State Health Plan and 12 Atrium Health hospitals in North Carolina.
Members of the plan using primary care provided with Atrium Health can continue at no change in cost or benefit. The agreement introduced by first-term Republican state Treasurer Brad Briner will “provide greater certainty for members and preserve access to key medical services – while supporting efforts to keep coverage affordable for teachers, state employees and their families.”
“Our objective has always been clear and consistent – we must offer our members high-quality care for affordable prices,” said Briner. “For the plan, that must include reduced prices from providers as compared to what they are charging today. This agreement includes meaningful affordability commitments from Atrium Health that help us improve access for members while supporting the long-term sustainability of the plan. This new provider tier system, which has now forged partnerships with all of the state’s leading hospital systems, is putting us on the right path.”
The State Health Plan is funded through the state budget’s direction on employer contributions, and investments to the budget such as the nearly $4 billion to prevent steep spikes in member premiums. Employee dependents pay 100% of dependent coverage out of pocket.
Atrium Health and the State Health Plan leaders have worked since July on addressing affordability concerns. In an Elon University Poll released Thursday, the top of the list for registered voters choices was “very important” or “somewhat important” for inflation or the cost of living (98%), general economy (97%), taxes (93%) and healthcare (92%).
The plan’s tiered network strategy will now be implemented in all of the state’s major healthcare systems.
“This agreement provides greater clarity and preserves access to important services, including primary care, emergency care, behavioral health services, rural care, children's hospitals and continuity of care for patients with complex medical needs,” said Michael Parkerson, executive vice president and chief managed health officer for Advocate Health within the Atrium Health umbrella.
If plan members visit Atrium Health rural hospitals in Alleghany, Anson, Cleveland, Columbus, Lincoln, Scotland, Stanly or Wilkes counties, their benefit is nearly identical to the benefit they have this year for out of pocket and deductible costs. Levine Children’s Hospital in Charlotte, Jeff Gordon Children’s Hospital in Concord and Brenner Children’s Hospital in the Triad also move to the access-level for plan members.
“Atrium Health is nationally recognized for its patient-centric care leveraging clinical research and education which gives North Carolinians access to cutting-edge expertise and care, and I am grateful for to their leadership for presenting multiple proposals for consideration to the plan,” said Briner. “The addition of a dozen of their hospitals will give our members an affordable choice to take advantage of this expertise.”
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