State health plan aims to take Atrium Health out of network, North Carolina treasurer says :: WRAL.com

Most hospitals and doctor’s offices that are part of Atrium Health will be taken out of network for the state health plan starting next year, North Carolina Treasurer Brad Briner told WRAL Thursday, an escalation in the months-long fight between the health plan and the company over health care prices.

The state health plan provides insurance to more than 750,000 state employees, retirees and their family members. Atrium is North Carolina’s largest health care chain, with hospitals and medical practices in Charlotte, Winston-Salem and other areas of the state. The goal is to soon expand into the Triangle as well, merging with Raleigh-based WakeMed to compete with UNC Health and Duke Health.

As state treasurer since last year, Briner oversees the state’s health plan, which is facing a deficit of hundreds of millions of dollars. His strategies for closing that gap have included raising premiums for state health plan members as well as creating a new tiered system for health care providers in which the 750,000 people on the plan would receive discounts for going to providers that offer the state lower rates, but would charge more for going to other providers.

Atrium is one of those other providers whose state-employed patients would start seeing their bills increase next year. The company announced a new program last week to subsidize those higher costs to keep its state employees’ patients from leaving for a competitor.

Briner sued to stop the practice, calling it illegal interference with the state’s health plan. He said that even if patients themselves didn’t pay more, the state health plan would. He lost, with a judge ruling in favor of Atrium during an initial hearing. As a result of that decision, Briner said, the state health plan plans to remove Atrium from the network.

Spokespeople for Atrium and its parent company Advocate Health did not immediately respond to a request for comment.

Briner noted that Atrium’s removal from the health plan’s network should not affect patients — as long as Atrium was still willing to pay extra to make up the difference for them, as it previously announced.

“We understand that this back and forth is destabilizing for our members, but this is all behind-the-scenes accounting,” Briner said in a written statement. “Members should expect to receive the same coverage as the scheme provides over the summer. »

Briner added, “One of my duties is to keep the state’s health plan financially solvent so that it can continue to serve as an incentive for teachers and state employees. I will not let a hospital system destroy the plan, raise the bonuses of every teacher and state employee, and put us in crushing debt.”

This is a developing story. Check back for updates.