Atrium Health and North Carolina State Health Plan (SHP) leaders reached an agreement bringing the hospital system back in-network for 750,000 state employees, teachers, retirees, and family members. North Carolina State Treasurer Brad Briner announced the agreement at the beginning of the State Health Plan Board of Trustees meeting on Tuesday and provided additional details in a press release.
 
Under the agreement, all Atrium doctors and facilities will be in-network for SHP members and part of the “access” tier beginning in 2027. Atrium was initially classified as a non-preferred provider, a tier in which its services would cost members significantly more than preferred and access tier providers. Members will still pay more with Atrium than if they use one of the preferred providers.
 
The agreement brings an end to a period of unease for SHP members who receive care from Atrium doctors or hospitals.
 
“We know there has been a lot of confusion for our members right now as we are in the middle of open enrollment,” Treasurer Briner said in a statement. “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 agreement, Atrium will discontinue the proposed Affordability Protection Program, and the state will withdraw its lawsuit seeking to block the program. State officials feared the subsidies would deepen the plan’s deficit as they work to restore its finances.
 
Despite the Atrium agreement, the SHP continues to face a major cash crunch due to rising healthcare costs and an increased number of members requiring expensive medical care. Savings from the new provider tiers are not expected until 2027. These concerns led the board to approve doubling monthly contributions from the Retiree Health Benefit Fund from $300 to $600 per retiree, freeing up $415 million. The money will eventually be repaid with interest, without raising member premiums.
 
SHP Executive Administrator Tom Friedman explained the state “needs money and time to invest in health,” and believes the preferred-provider structure will help the SHP do so.
 
The full presentation to the board can be accessed here and the meeting recording here.
 
Open enrollment for SHP members is currently open and will end on November 6. Start enrollment here. Please reach out to NCASA with any questions as we work closely with SHP staff to address specific questions pertaining to the plan.