Today the Department of State Treasurer and Novant Health announced the first major expansion to the State Health Plan’s (Plan) Lantern surgical benefit. This will significantly broaden access to no-cost, high-quality surgical care for hundreds of thousands Plan members across the state. The announcement was made during a press conference at Novant Health Kernersville Medical Center.
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The State Health Plan (Plan) held its inaugural meeting of the newly established Medical Policy Advisory Committee on Feb. 25. The committee’s work is intended to strengthen the Plan’s ability to evaluate emerging treatments, ensure evidence-based decision-making and promote high-quality, patient-centered care for members.
Votes taken by the State Health Plan (Plan) Board of Trustees yesterday aim to improve health outcomes for members while also considering cost transparency and long-term affordability. The trustees approved contracts with three clinically integrated networks (CINs): Aledade, Community Care Physician Network and UNC Health Alliance. These agreements represent the first phase of the Plan’s new preferred provider strategy.
The State Health Plan (Plan) has completed a difficult year, but now is projecting that the massive deficit it was facing on Jan. 1 has been addressed. Today the State Health Plan (Plan) Board of Trustees heard from Plan staff and consultants on where things stand now and strategies underway for 2026.
The North Carolina Department of State Treasurer and CVS Caremark (Caremark) have successfully reached an agreement regarding their ongoing contract dispute, securing hundreds of millions of dollars on behalf of the members of the State Health Plan (Plan). This agreement provides certainty to both parties around pharmacy pricing and payments. Additionally, this agreement gives the Plan the ability to negotiate directly with manufacturers of GLP-1s to potentially restore coverage of weight-loss medications to members.
After months of negotiations, the North Carolina State Health Plan (Plan) is pleased that Duke Health prioritized continued service to its members. The deal reached between Duke Health and Aetna, which serves as the Plan’s third-party administrator, will deliver high-quality care with a focus on better outcomes and efficiency. We particularly want to thank Dr. Tom Owens of Duke Health for his role in seeking an innovative solution to these negotiations, and our partners at Aetna for their steadfast commitment to affordability.
The North Carolina State Health Plan (Plan) Board of Trustees approved a resolution today to direct Plan staff to take necessary actions if Duke Health and
Negotiations are still ongoing between Duke Healthcare and Aetna, with their contract set to expire in less than a month. The State Health Plan (Plan) is Aetna’s largest client in our state and is watching the talks closely. In preparation for potential failed negotiations, Plan members who use Duke Healthcare will be receiving a letter from the Department of State Treasurer this week to discuss next steps.
In addition, State Treasurer Brad Briner released this statement to all Plan members this morning explaining why this negotiation is so important for everyone:
The North Carolina State Health Plan is following through on its promise to not only provide support when members are in need, but also provide the needed prevention tools to help members stay healthy. As part of these efforts, State Treasurer Brad Briner is announcing a new partnership targeting rural, more difficult to serve communities. Hello Heart, the digital leader in preventive heart health, will now work to empower eligible Plan members to better understand and improve their heart health.