(Raleigh, N.C.) – State Treasurer Dale R. Folwell, CPA, and the State Health Plan (Plan) announced today that the Plan will reopen the N.C. State Health Plan Network for new medical providers to join. Medical providers will have from Sept. 15 to Oct. 15, 2020, to sign up. Providers who join will be included in the network effective Jan. 1, 2021.
The N.C. State Health Plan Network (Network), which went live Jan. 1, 2020, currently consists of more than 25,000 providers who signed on to the new network last year as part of the Plan’s Clear Pricing Project (CPP). Under the CPP, the Plan moved away from a commercial-based payment model to a reference-based, transparent pricing model tied to Medicare rates. Providers in the Network will be reimbursed for their services at Medicare rates plus an average of 60 percent.
The Plan’s Board of Trustees approved 2021 plan-design changes that highlight CPP providers as those who support transparency and affordable health care. Members will reap the benefits of these changes as they will be able to visit a CPP Primary Care Provider for a $0 copay, compared to the current copay of up to $45, and a CPP Specialist for as little as $40, compared to the current copay of between $80 and $94.
“We’re excited to offer these Clear Pricing Project cost savings to our hardworking Plan members and their families,” said Treasurer Folwell. “This is a perfect opportunity for new providers to join the N.C. State Health Plan Network as we lower health care costs and encourage members to use these providers. As Warren Buffett said, ‘medical costs are the tapeworm of American competitiveness.’ Ultimately, getting rid of secret pricing and contracts will be the only medicine to reduce those costs.”
In June 2019, Community Care Physicians Network (CCPN) joined the Network. Today, CCPN will join forces with independent practices from across the state to form the Value Alliance. This new alliance will support the Clear Pricing Project and work with the Plan and the Plan’s vendor partner, Public Consulting Group, to develop alternative payment model strategies.
“We are pleased to announce the development of Value Alliance, a coalition of Community Care Physicians Network and other independent provider networks from across the state that will deliver a high-quality and value-based model of care to state employees across North Carolina. We look forward to caring for state employees in North Carolina communities and will seek to be consistent and innovative in our care delivery, with the goal of achieving better health outcomes for State Health Plan members while strengthening independent primary care in North Carolina,” said Conrad L. Flick, M.D., and Dale Owen, M.D.
Providers interested in joining the Plan network can find additional information on the Plan’s website at https://www.shpnc.org/ncshpprovidernetwork.
The network will continue to be administered by Blue Cross NC, the Plan's third-party administrator. The Clear Pricing Project does not impact retirees on the State Health Plan’s Medicare Advantage Plans.
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.