As part of the ongoing efforts to keep the State Health Plan (Plan) affordable for its 750,000 members while keeping it solvent, Atrium Health and the Plan have entered into a new contract. Atrium Health came into this multi-year agreement with the goal of making sure members can keep receiving care at its leading hospitals, and from the physicians and care teams they know and trust.
This new contract comes after the Plan built its tiered network to provide high-quality care at a lower cost to its members. Atrium Health created its Affordability Protection Program to reduce costs for its patients. This new agreement now achieves both organizations’ goals.
“Thank you to our hundreds of thousands of members who have trusted us and trusted the process to bring you the high-quality care you want at costs we can all afford,” said Treasurer Brad Briner, who chairs the State Health Plan Board of Trustees. “We know there has been a lot of confusion for our members right now as we are in the middle of Open Enrollment. We hope this agreement provides members with more clarity about provider tiers and puts concerns to rest while avoiding drastic premium and benefit changes statewide.”
Under the contract, the Plan will add all remaining Atrium Health hospitals and physicians to its in-network Access tier, lowering costs for the Plan, its members and the taxpayers who help fund it. Plan members who rely on Atrium Health will now have in-network Access tier coverage for all currently existing Atrium hospitals and specialty care services, allowing members to make appropriate decisions about their health care before Open Enrollment ends on November 6.
“For every teacher, state employee and family member we serve at Atrium Health, this new agreement is about providing the peace of mind that comes from knowing the caregivers they trust will remain within reach,” said Steve Smoot, president of Advocate Health's North Carolina and Georgia Division, which Atrium Health is a part. “We are grateful to move forward together with a shared commitment to making high-quality care more accessible and affordable for every State Health Plan member who depends on us.”
Because members now have access to care through the Plan’s own network, both organizations agree that the Affordability Protection Program is no longer needed, and Atrium Health will sunset it when the agreement takes effect. Additionally, the current legal complaint filed by the State Health Plan will be withdrawn.
The Plan and Atrium Health recognize the past few months have been unsettling for members and their families, and each have committed to put any differences aside to move forward and keep working together for the benefit of every teacher and state employee who counts on them both.