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Analysis

Hospitals Win Showdown With N.C. Treasurer Over Public Health Plan

By Steven Porter  
   August 12, 2019

The resulting hybrid network will include more than 68,000 healthcare providers, more than twice as many as had been in the state's plan alone.

More than 720,000 public school teachers and other state employees in North Carolina will have access to a broad network of healthcare providers in 2020 after Treasurer Dale Folwell agreed to compromise on his proposal to set reimbursement rates for the state's health plan at about double Medicare rates.

Only five health systems had signed onto the plan early last week, adding to concerns that beneficiaries might be stuck with a severely restricted network. But those concerns melted Thursday, when Folwell announced a change that would allow several other major providers to remain in-network, as The Charlotte Observer's Hannah Smoot reported.

In addition to the systems that had signed onto Folwell's proposal, the state will allow health systems to keep their existing agreements with Blue Cross Blue Shield of North Carolina. That means major systems that had resisted the proposal, including Atrium Health, Novant Health, Duke Health, and UNC Health, could continue to serve beneficiaries of the public health plan, as the Observer reported.

Whereas the state's plan alone would have included about 28,000 providers, the hybrid network will reportedly include more than 68,000 providers.

Steven Porter is an associate content manager and Strategy editor for HealthLeaders, a Simplify Compliance brand.


KEY TAKEAWAYS

The treasurer's proposal had set reimbursement rates in reference to Medicare rates in 2020.

The hybrid plan means public employees will have in-network access to several more major health systems.


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