(The Center Square) – The state of North Carolina’s partnership with a private company to lower health care costs for employees has already reduced the price of surgeries and led to some patients not having to have surgery at all.
The company, Lantern, helps clients save money by creating an incentive program for going to lower-cost but high quality providers. That’s important when health care in rural areas of the state can be eight times that of urban offerings.
For state employees, the benefit is no out of pocket costs for patients who use a doctor in the Lantern system.
“We’re ultimately trying to get people to the best possible care,” Lantern Chief Medical Officer Dickon Waterfield said Thursday in a discussion with Thomas Friedman, executive administrator of the North Carolina State Health Plan. “In many cases, that’s conservative care.”
Lantern has already helped “a great number” of patients avoid surgery, Waterfield said.
“We want surgery to be the last option but recognize the financial incentive isn’t always in place to not cut,” Friedman told TCS. “So we’ve partnered with Lantern to create a nonsurgical route to incentivize things like physical therapy. If the member is able to improve their health without surgery then we all share in the benefit and savings.”
As an example of the variation of health care prices in North Carolina, Friedman cited a provider in a rural part of the state that is eight times more expensive than one of the providers in the Raleigh-Durham area.
“I could pick everyone up in a limousine, take them to the nicest hotel for three days and then take them back home and still save thousands of dollars,” Friedman said.
Pharmacy costs are next on Friedman’s agenda for lowering costs in the state health plan.
“Our medical pharmacy costs continue to go up astronomically every year,” he said.
Friedman hopes to lower those costs as well. The savings could go toward helping to lower the number of patients with chronic health conditions.
“Seventy percent of our members have at least one chronic condition,” he said. “I need to save money through Lantern to invest in getting folks healthier.”
Friedman said his strategy is to “win the short game to play the long game” of reducing chronic diseases.
“Given that we are on a fixed budget, we need money to invest in population health,” Friedman said.
