1 system joins North Carolina's controversial reimbursement plan in 2nd sign-up period

Mackenzie Bean -

Only one health system — Gastonia, N.C.-based CaroMont Health — agreed to join the North Carolina State Health Plan during the second sign-up period, which ended Aug. 5, reports the Winston-Salem Journal.

At present, four of the state's 126 hospitals and 27,000 of the state's 61,000 providers have signed the Clear Pricing Project contract backed by the State Health Plan. The contract contains a controversial reimbursement formula that would cap payments at 160 percent of the Medicare rate for inpatient care and 230 percent of the Medicare rate for outpatient services.

Greensboro, N.C.-based Cone Health told employees it would not join the State Health Plan July 1, which prompted Cone Health Assistant Director of Finance Frank Kauder to send members of the State Health Plan's board and State Treasurer Dale Folwell an email telling them to "burn in hell."

Winston Salem, N.C.-based Novant Health said it is still reviewing the contract. UNC Health Care in Chapel Hill has been lobbying for the state to delay, if not end, the contract's rollout.

Hospitals and physicians who do not sign the contract will become out of network for more than 727,000 State Health Plan members effective Jan. 1, 2020.

More articles on payer issues:

Humana beefs up employee bonuses after $940M profit in Q2 
Vermont issues cease and desist orders against 5 unlicensed health insurance sellers
BCBS of Michigan hit with $40M lawsuit over provider payments

Copyright © 2024 Becker's Healthcare. All Rights Reserved. Privacy Policy. Cookie Policy. Linking and Reprinting Policy.