(The Center Square) – A key to controlling increases in North Carolina state employee health care costs lies is lowering the number of patients with “chronic” diseases such as diabetes, heart conditions, cancer and arthritis, the director of the program said Friday.
An estimated 70% of employees on the state insurance plans suffer from one of those conditions, Thomas Friedman, executive administrator of the State Health Plan, told the board that governs the plan.
Nearly 750,000 people access the plan, inclusive of teachers, state employees, retirees, community college and university staff, and dependents of those respective groups. While the state remains without its two-year state budget that was due July 1, a mini-budget measure by the General Assembly in July appropriated $100 million of taxpayers’ money to aid a $500 million deficit.
Lowering the percentage will not be a quick or easy task, Friedman said.
“We didn’t get to 70% of people with a chronic condition in some capacity overnight and we’re not going to solve it overnight,” Friedman told the State Health Plan board of trustees. “We are going to manage it over time. But this is the long game. But in the short term we need to very much address the challenges in front of us.”
In many areas of health care there are “significant variations” in cost that aren’t driven by the volume of patients, Friedman said.
“HIgh variance of costs is what we have to attack,” he said. “We have to make it affordable and simple for members to go to lower cost, high quality providers.”
One example the plan is now offering is a program called Lantern, which offers a “high quality, carefully selected surgeon network” for nonemergency procedures with no cost to the patient.
Geography plays a role, with patients in rural areas having to travel farther to reach health care facilities.
Friedman cites medical imaging as one example.
“In the northwestern part of the state, in the eastern part of the state, and the southeastern part of the state, there are not a lot of free-standing imaging options,” he said. “Folks who need complex imaging are either traveling or going to a hospital where it is more expensive.”
More lower-cost mobile imaging units would help, Friedman said.
Imaging is an area that the state could get the same quality services for half the price, he added.
“These are concepts we need to start driving home for members,” Friedman said. “We need to start making benefit differentials to make it really easy and really simple for our folks to get there.”
In urban areas, it is not unreasonable to ask members to drive two extra miles to save 50% of the cost of a medical procedure, Friedman added.
“They will save money too,” he said of the patients. “It will save them money and will it save us even more money.”
