In May, North Carolina State Treasurer Dale Folwell directed Blue Cross and Blue Shield of North Carolina to begin seeking significant rate reductions in “major” provider contracts on behalf of the State Health Plan. Wednesday, Treasurer Folwell brought together representatives of various healthcare organizations, including the NCAFP, to discuss ways to lower costs in the State Health Plan, that represents 700,000 state and local government employees as well as retirees. Organizations represented in addition to the NCAFP included the NC Pediatric Society, the NC Psychiatric Association, the NC Medical Society, the NC Healthcare Association (formerly NC Hospital Association), the State Employees Association, the Retired Government Employees Association, Blue Cross and Blue Shield of North Carolina and several other healthcare organizations, as well as the Treasurer and his staff. The Treasurer has a goal of saving $300 million in the next plan year and maintaining that savings over the next five years on what he characterized as unsustainable spending growth by the State Health Plan.
Executive Vice President Greg Griggs and Government Affairs Consultant Stephen Kouba attended on behalf of the Academy. Griggs spoke on the value of primary care and the role family physicians play in coordinating care, improving health and lowering costs. These points were well received in the meeting and Treasurer Folwell reiterated the importance of family physicians in any setting. The meeting included a long and detailed discussion of healthcare transparency, the need for claim and referral outcome data at the point of care, the need for a greater emphasis on value-based care, and a better examination of the key cost drives in the plan. The discussion focused on providing the right care at the right time in the right setting to eliminate unnecessary hospitalizations and over-utilization of tests and procedures.
Treasurer Folwell closed the meeting by saying the dialogue was a good beginning, but that his office is looking for some immediate changes that will provide long-term cost relief. However, he did not commit to a specific rate cut. The NCAFP team will continue to follow up with the Treasurer’s staff and coordinate with other provider groups as these conversations evolve over the next several weeks and months.