SEANC stands with Folwell on Health Plan reforms
Oct 10, 2018
The State Employees Association of North Carolina today announced its support for State Treasurer Dale Folwell’s plan to base provider reimbursements paid by the State Health Plan on a reference-based government pricing model rather than a commercial-based model.
“Consumers can’t make informed health care choices without transparency in pricing,” said SEANC Executive Director Robert Broome. “Treasurer Folwell is keeping his promise to State Health Plan members and taxpayers to be open and honest about the cost of their health care, while remaining committed to keeping those costs down.”
The State Health Plan suffers from a severe lack of transparency in payment methodology. In September, Folwell showed SEANC Convention delegates a document he received from UNC Health Care that was supposed to provide details about roughly $270 million in charges to the State Health Plan. The 100-page packet was so heavily redacted that entire pages were blocks of black ink.
“That is wrong. State employees, retirees and other taxpayers have a right to know what they are paying for when it comes to health care,” continued Broome.
Under the current model, the price for some procedures compared to the Medicare reimbursement rate varies from as little as 71 percent to a budget-busting 994 percent. A strategy that caps reimbursement at an average of 177 percent of Medicare rates will save state employees and retirees more than $60 million. This move will benefit taxpayers as part of Folwell’s plan to reduce overall State Health Plan costs by more than $300 million. This savings will give the State Health Plan the opportunity to freeze or reduce premiums, co-pays and deductibles making the Plan more affordable for state employees and their dependents.
SEANC has advocated for years in favor of a transparent reimbursement model that provides quality health care with affordable pricing that is fair, reasonable and predictable.