(The Center Square) – In the battle against rising health care costs, the North Carolina state employees health system is offering incentives to members who choose lower-cost medical providers.
The board that governs the health care system voted Tuesday to work towards offeringd a three-tiered plan for employees copays and deductibles based on the providers they choose for the medical treatment. An estimated 750,000 get coverage through the State Health Plan, including teachers, state employees, retirees and their families.
Higher costs providers would come with higher copays and deductibles for members. Lower cost providers might come with no out-of-pocket expenses for members.
The details onf the numbers for copays and deductibles will be discussed further at a later meeting.
The savings to the state could eventually be as high as $600 million a year, Thomas Friedman, executive director of the state plan, told the governing board Tuesday.
“That’s a lot of money,” Friedman said. “But we’ve got to incentivize people to do those things. We’ve got to communicate it. I think part of my job is to socialize this, talk to our members about where they have opportunities. This is hard. It’s just complicated. Giving people enough lead time to make these choices is really critical.”
The state is already partnering with a private company, Lantern, to offer surgeries with no out of pocket costs if the patient chooses a provider in Lantern’s network. The providers offer lower costs in exchange for the volume of patients offered by the state health plan. Lantern screens the providers to make sure they offer high quality and is based by the state based on a percentage of the savings.
Tuesday’s vote was meant to be a “declaration of intent” by the state so that it can start discussions with providers, Friedman said.
“When we go sit down with large health systems and talk about giving us a significant discount, it can’t be a theoretical conversation,” Friedman said.
All health care providers should want patients from the state health plan because of its size and stability, he added.
“Whether it be pending recessions, artificial intelligence, issues with Medicaid budgets, Medicare Advantage pricing, any number of things, state employees in North Carolina are here, they are going to stay here,” Friedman said. “We are the business you want, we are the people you want to partner with. We have a tremendous opportunity to partner and improve health and reduce costs together.”
Health providers can decide against partnering with the state but, Friedman said, “It’s going to be more expensive for our members to go there and it’s going to be more affordable for our members to go with our partners who are committed to working with us.”
