The North Carolina State Treasurer is promoting a new healthcare provider payment model tied to federally-determined Medicare rates (reference-based pricing) as the panacea for the long-term viability of the State Health Plan. Despite numerous conversations with physicians and other healthcare leaders across the state, the treasurer has chosen to ignore the growing movement to value-based care. In fact, he has said he doesn’t believe it can work, despite numerous successful examples here in North Carolina and around the country, the recommendation of his own staff, and the endorsement of his third party administrator, Blue Cross and Blue Shield of NC.
The treasurer and his team are perpetuating a false notion that providers will make a profit from payments tied to Medicare prices, which demonstrates their lack of understanding of healthcare financing and disregard for the long-term damage this model will create. Medicare, like other government programs, already reimburses well below the cost to provide care. Forcing North Carolina’s hospitals and providers to accept a “one tool in the toolbox’ approach will force cutbacks in services and may result in hospital closures. These proposed changes will mean less access to trusted doctors and hospitals and less access to high-quality care – for all North Carolinians, not just the Plan’s 730,000 members.
Improving the health of the communities where we live and work is the collective mission of North Carolina’s hospitals and health systems. Creating a stronger, more sustainable state health plan is an important task that requires engagement from all parties involved. Concerned North Carolinians should contact state leaders about adopting fiscally responsible solutions that improve health while also ensuring access for all.
If you would like to know more about this issue, contact communications@ncha.org.