We’re going to start paying you less, are you in or out……..”
This is exactly what one can expect when a plan sponsor informs hospitals “We’re going to start paying you less, so are you in or out?” The state of North Carolina made that announcement in advance of implementing a Reference Based Pricing plan for over 700,000 state employees effective January 2020.
Since then all hell has broken out. Hospitals are screaming, threatening dire consequences, and refusing to agree to accept a pay cut. They want more than 185% of Medicare.
The N.C. state treasurer who has been pushing the state towards adopting Reference Based Pricing issued this statement a few days ago in response to these hospital attempts to stop the effort.
FOR IMMEDIATE RELEASE – 7/1/2019
Contact: Beth Horner (919) 814-3820
Health Care Attempts to Distract from Its Dark Money Scandal
Pushes Counterproposal Against Transparency to the Detriment of Its Own Employees
(Raleigh, N.C.) – State Treasurer Dale R. Folwell, CPA, and the State Health Plan (Plan) announced today that UNC Health Care submitted a counterproposal to the Clear Pricing Project to Gov. Roy Cooper and legislative leaders to distract from its recent dark money scandal as well as today’s deadline for providers to sign up for the Plan’s new transparent network.
“The State Health Plan has worked tirelessly to sign up providers before today’s deadline for the new North Carolina State Health Plan Network. Our goal and fiduciary responsibility has always been to enhance transparency and lower health care costs for our 727,000 members,” Folwell said. “I find it offensive that the state’s very own hospital would deliberately try to divert attention from our efforts at the risk of costing its own employees, members and taxpayers like them even more for health care services.”
The Treasurer and State Health Plan staff have had several meetings with UNC Health Care over the last year. They have had numerous opportunities to present their concerns to the State Health Plan Board of Trustees. Their 11th hour counteroffer was a silly back-to-the-future strategy that was presented to the previous Treasurer and State Health Plan administration over three years ago and was rejected, because of its lack of transparency and no concrete, measurable savings to the Plan.
The public should be troubled and alarmed that the President of UNC Health Care Network Hospital, Chris Ellington, approved spending tens of thousands of taxpayer dollars on a dark money political group, called Partners for Innovation in Healthcare, to stop the Clear Pricing Project from moving forward. The fact that Ellington sits on the board of the North Carolina Healthcare Association, which sponsors Partners for Innovation in Healthcare, represents a huge conflict of interest. UNC Health Care still has the opportunity to do the right thing by signing on to the Clear Pricing Project (CPP).
The North Carolina State Health Plan Network is the result of the Clear Pricing Project (CPP) announced last year. Under CPP, the Plan will move away from a commercial-based payment model to a reference-based, transparent pricing model tied to Medicare rates. Health care providers will be reimbursed for their services at Medicare rates plus an average of 82 percent. Plan members will save more than $50 million.
Providers have until tonight at midnight to sign up to join the North Carolina State Health Plan Network. Information for providers is available at www.bluecrossnc.com/providers/ncstatehealthplannetwork.
The State Health Plan, a division of the N.C. Department of State Treasurer, provides health care coverage to more than 727,000 teachers, current and former lawmakers, state university and community college personnel, active and retired state employees, and their dependents.
