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Folwell reforms would boost payments to independent providers

Carolina News | Dan Way | Jan. 8, 2019

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RALEIGH — For years, independent health-care providers have resisted consolidation in the medical market. State Treasurer Dale Folwell hopes to lend them a hand with State Health Plan payment reforms.

“We think the long-term success of health care in North Carolina is going to be based on independent physicians, independent behavioral health specialists, and actually independent hospitals who are able to figure out how to provide the highest-value, lowest-cost product to any of their customers,” Folwell said Tuesday, Jan. 8 during his monthly Ask Me Anything teleconference with reporters.

Reforms he is leading will offer many health-care providers pay increases from the State Health Plan because they earlier reimbursement plans short-changed them.

Folwell has rolled out a reference-based pricing model. Medicare reimbursement rates are the starting point, and are negotiated up from there. He said on average the state will pay health care providers 177 percent of the Medicare rate. He projects a $300 million savings for the State Health Plan, and $65 million for members.

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