Politics
Atrium hospitals to leave state health plan network as treasurer disputes cost protections
North Carolina Treasurer Brad Briner says most Atrium Health facilities will move to the State Health Plan’s costliest tier in 2027. The change comes amid a dispute over Atrium’s promise to cover eligible members’ deductibles and coinsurance, with plan leaders warning premiums could rise.
Most Atrium Health facilities will be classified as out of network for members of the North Carolina State Health Plan starting in 2027, Treasurer Brad Briner announced Wednesday, escalating a dispute that could leave public employees and retirees uncertain about their health care costs.
Under the plan’s new tiered system, members pay less out of pocket when they use providers offering deeper discounts. Out-of-network care is in the most expensive tier. Atrium had initially been placed in a non-preferred tier before Briner’s announcement.
The conflict centers on Atrium’s Affordability Protection Program, announced Oct. 6. Beginning Jan. 1, the health system says it will cover eligible State Health Plan members’ deductibles and coinsurance for care at Atrium facilities.
Briner has argued that Atrium’s program could undermine the plan’s financial stability. He says moving the facilities out of network is intended to protect the plan and could save the state hundreds of millions of dollars. He has also said employees would not pay more if Atrium honors its commitment. State Health Plan leaders, meanwhile, have warned that premiums may need to increase to keep the plan financially stable.
A judge on Tuesday denied the plan’s request to block Atrium’s affordability program. Atrium did not respond to a request for comment Wednesday night.
The stakes extend to workers who depend on the plan in retirement. Julie Fortner, a retired Cleveland County Schools employee who worked nearly 30 years, said state insurance was an important benefit she had earned. She has received care through Atrium and said the changes have left her unsure what to expect.
Fortner said she worries members may panic as they try to make decisions amid confusing insurance terminology and political disputes. Atrium, in announcing its program, said it wanted state employees to be able to keep receiving care from providers they know and trust.