Atrium Health, State Health Plan reach compromise

By Alan Wooten | The Center Square

Health / Affects Local – In exchange for ending a pricing plan, Atrium Health has been returned to in network for the State Health Plan in North Carolina to resolve a conflict that escalated and generated confusion just as the healthcare open enrollment period was beginning.

The move announced jointly by Atrium and first-term Republican state Treasurer Brad Briner on behalf of the nearly 750,000 teachers, state employees, retirees, lawmakers active and retired and members of higher education is expected to keep the plan solvent, and allow members to get care at leading hospitals from physicians known and trusted. The plan’s in-network access tier will include all Atrium Health hospitals and physicians.

Atrium is trying to merge with Raleigh-based WakeMed. Federal and regulatory approvals are still needed; WakeMed and Atrium Health have signed the terms.

Earlier this month, Atrium’s attempt to subsidize members not choosing UNC Health or Novant Health led to the State Health Plan saying it would be moved out of network on Jan. 1. Briner, chairman of the plan, said the solvency of the plan was at stake.

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The State Health Plan was projected for a $500 million deficit this year, and $1 billion in 2027.

In a statement made available to The Center Square, Briner said in part, “We know there has been a lot of confusion for our members right now as we are in the middle of Open Enrollment. We hope this agreement provides members with more clarity about provider tiers and puts concerns to rest while avoiding drastic premium and benefit changes statewide.”

Briner and the board by one week extended the open enrollment period to Nov. 6.

In a statement made available to The Center Square, Atrium Health’s Steve Smoot said in part, “For every teacher, state employee and family member we serve at Atrium Health, this new agreement is about providing the peace of mind that comes from knowing the caregivers they trust will remain within reach. We are grateful to move forward together with a shared commitment to making high-quality care more accessible and affordable for every State Health Plan member who depends on us.”

Smooth is president of the North Carolina and Georgia Division.

The Affordability Protection Program will sunset it when the agreement takes effect. The litigation by the State Health Plan is being withdrawn.

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Alan Wooten has been a publisher, general manager and editor. His work has won national or state awards in every decade since the 1980s. He’s a proud graduate of Elon University and Farmville Central High in North Carolina.

THE SHELBY INDEPENDENT.