About a week ago, State Treasurer Dale Folwell raised reimbursement rates for hospitals who sign on as network providers for the State Health Plan (SHP). Thursday morning, Carolina Journal’s Julie Havlak reported that many hospitals are still not willing to accept his offer. According to Havlak:

The State Health Plan is due to go broke in four years. Folwell hopes to save it with his Clear Pricing Project (CPP), which would tie reimbursements to Medicare prices. He describes the current system as a blank check, which he plans to rip up and replace with a transparent pricing system. 

Folwell’s most recent offer raised reimbursement rates from 182 percent to 196 percent of Medicare’s payments in an attempt to entice more hospitals into the plan. Several hospitals and hospital conglomerates, such as Vidant Health, have refused to sign up to provide health care for state employees – citing potential financial losses. Hospitals, instead, are calling for further study into alternative SHP reforms. According to Havlak:

[Atrium Health Spokesperson, Chris Berger] points to House Bill 184, which would create a committee to study the State Health Plan and the CPP. In effect, the bill would push any changes back a year, delaying reference-based pricing and creating the opportunity to scuttle the reforms entirely…

Along with eight legislators and the plan executive administrator, the committee would be staffed by four medical-industry figures and three representatives of state employees. The bill passed the House and is parked in the Senate Rules Committee.

However, Treasurer Folwell is not convinced the bill will do any good. Havlak quotes Folwell as stating:

“They’re pouring you the same Kool-Aid that they’ve been serving for years,” Folwell said. “The only reason that they would lose money is that they’ve been using the State Health Plan for enormous profits for a long time. This is what they always say. The fact is that they are in favor of secret contracts and higher costs.”

H.B. 184 has been in the Committee on Rules and Operations of the Senate since April 4, 2019.

Read the full story here. Stay up-to-date with the Clear Pricing Project story here.