State Treasurer Dale Folwell was in New Bern Tuesday to outline the Clear Pricing Project, a plan to keep North Carolina’s State Health Plan solvent beyond its projected fiscal lifespan. At current spending levels of nearly $3.3 billion per year, the plan is projected to run out of money in 2023.
...According to Folwell, the Clear Pricing Project, which would begin January 1, 2020, is an effort to change how doctors and hospitals are reimbursed under the State Health Plan. He said the proposal would save taxpayers $258 million annually and plan members $57 million in out-of-pocket expenses. On average, health care providers would be reimbursed for their services at Medicare rates plus an average of 82 percent. The State Health Plan Board of Trustees has unanimously approved the Clear Pricing Project.
Allen Johnson and the News and Record
have yet to chime in on a plan the NC House voted to gut
According to Folwell, the N.C. State Health Plan has one of the lowest participation rates of any plan its size.
...The Clear Pricing Project has met resistance in the N.C. General Assembly. Earlier this month, the state House voted 75-36 to create a special panel that would study how to realign the State Health Plan. The move would essentially block Folwell from implementing changes to the current provider reimbursement system...
“Right now, a starting teacher or trooper has to work one week out of every work month just to afford the family premium for health care,” said Folwell. “The current plan is unsustainable. Whether it’s the Governor’s budget or the General Assembly’s budget, the increased money we get is 4 percent a year and our health care costs are going up more than that and our prescription drugs are double digit.”
Folwell explained that ...its auditors “do not have access to the contracts and cannot verify that the State Health Plan is receiving the proper contractual discounts.′
...Folwell said a public records request his office made for medical procedure price lists from UNC Health Care provided only reams of redacted pages.
...The North Carolina Healthcare Association, which represents hospitals, has also come out against the Clear Pricing Project. President Steve Lawler has characterized the plan as an “approach to just reduce rates, versus an approach to improve people’s health, improve the health of communities.”...
...“We have some providers, not hospitals, that are charging 700 to 800 percent of Medicare right now.”
The State Employees Association is “100 percent” behind the Clear Pricing Project proposal, said Folwell.
https://www.jdnews.com/news/20190416/nc-treasurer-folwell-offers-remedy-for-state-health-plan-woes
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Here's the votes from the house.
The Ayes are the bad guys who voted to keep ripping off North Carolinian employees and taxpayers, including John Faircloth, Cecil Brockman, Ashton Clemmins, Amos Quick and Pricey Harrison, who should be ashamed of themselves for putting their donors ahead of their constituents;
Cone Health and others are running Rackets, and Editorial Board Editors like Allen Johnson help let the healthcare industry get away with it;
“There’s no turning back,” Folwell said of his plan. “People are no longer going to accept not knowing what they spend 20 percent of their income on.”
A plan by State Treasurer Dale Folwell to reform the nearly insolvent State Health Plan faces legislative pushback, prodded by hospitals and large medical providers. Folwell has no plan to abandon the reforms, which actuaries say would prevent the plan from going broke within four years.
...Primary sponsors of H.B. 184 received notable political contributions from the N.C. Healthcare Association in 2018: Reps. Josh Dobson, R-McDowell, $5,200; Julia Howard, R-Davie, $2,000; William Brisson, D-Bladen, $3,000; and Gale Adcock, D-Wake, $6,200."
https://www.carolinajournal.com/news-article/treasurer-hospitals-at-loggerheads-over-state-health-plan-reforms/
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Allen Johnson let Cone Health run an opinion piece on keeping the con in place by the CEO, but has yet to write anything himself on the subject;
"Terry Akin: Why not better care and lower costs for teachers and troopers?
...For Cone Health, the state treasurer’s cuts — $26 million a year to our bottom line — are just as significant. This would reduce our yearly operating margin by nearly half. That means Cone Health would have almost 50 percent fewer dollars to invest in facilities, employees and services that keep you healthy and well. Frankly, it would be a major challenge for our organization to weather such an extreme reduction.
...At Cone Health and other health networks, we have a better, proven solution that is already keeping people healthier and saving substantial health care costs. This way forward is called “value-based care.”
Bullshit
Here’s how it works: We agree to a budgeted amount of money to care for a certain number of people. If we provide high-quality care for less than budgeted, we share in the savings. If we spend more than budgeted, we cover the deficit. This model ensures we focus not only on those who are sick, but do all we can to keep people healthy and well.
...For the last seven years, Cone Health has refined this model with more than 1,500 physicians and other providers in an accountable care organization (ACO) known as Triad HealthCare Network.
https://www.greensboro.com/opinion/columns/terry-akin-why-not-better-care-and-lower-costs-for/article_d59bfb6c-6ca4-5a58-8f9d-a5d325d67802.html
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Where do State Senators Gladys Robinson, Michael Garrett, Rick Gunn and Jerry Tillman stand?
If there is no effort on the part of local media to highlight the issue, our 'leaders' may find they can ride out the storm without getting called out by those who are supposed to, like the News and Record's Allen Johnson
