N.C. physicians group agrees to participate in treasurer’s cost-saving project

The largest physicians group in eastern North Carolina has agreed to participate in State Treasurer Dale Folwell’s cost-saving Clear Pricing Project.

ECU Physicians, the medical practice of the Brody School of Medicine at East Carolina University, has signed a contract to join the N.C. State Health Plan Network, Folwell and the State Health Plan announced Wednesday, June 26. That raises the total number of providers that have joined in the reform movement to more than 31,000, Folwell told Carolina Journal.

“Thousands of state employees who work at ECU, Pitt Community College, area school systems, and other state agencies in eastern North Carolina can be at ease in 2020 knowing that they are in network,” Folwell said.

“The Brody School of Medicine was founded on a mission to develop and train primary care physicians and to provide expert and compassionate health care for the people of eastern North Carolina,” Dr. Mark Stacy, dean of the Brody School of Medicine, said in a joint news release with the Treasurer’s Office. 

“It is our privilege and responsibility to provide top-quality care through the clinical faculty and staff at ECU Physicians to our fellow participants in the State Health Plan,” Stacy said. 

Getting ECU Physicians into the State Health Plan network is a coup of sorts for Folwell. Vidant Medical Group officials have harshly criticized his reforms. Previously, they clashed with the treasurer over his concerns with Vidant trying to merge with and assume control of ECU Physicians. Vidant ultimately discontinued merger talks.

Folwell said State Health Plan officials’ discussions with ECU Physicians over the past few weeks is an example of entities coming together to attack the state’s health-care problems, and not attack people.

Vidant Health CEO Michael Waldrum and other Vidant officials “have never said anything, offered anything, actually attacking the problem of lack of transparency and runaway costs,” Folwell said.

Waldrum also is chairman of the N.C. Healthcare Association Board of Trustees, which represents hospitals and large health systems. It has ties with Partners for Innovation in Health Care. That 501(c)4 organization has been running attack ads against Folwell’s reforms.

“With the supposed millions of dollars that they have spent attacking the Clear Pricing Project, not one solution has come forward,” Folwell said.

Folwell said he was disappointed, not surprised, that publicly owned UNC Hospitals was caught funneling money through the N.C. Healthcare Association to Partners for Innovation in Health Care. 

“I think it reflects just the tip of the iceberg,” Folwell said. “My disappointment comes from the fact that taxpayer money is used against the policy of a public official which was meant to decrease health care costs on the very employees who work for them.”

UNC Hospitals’ refusal to share billing and cost information with the Treasurer’s Office triggered Folwell’s decision in 2018 to enact reforms.

The Clear Pricing Project incorporates a health-care model known as reference-based pricing. It pegs provider payments to Medicare reimbursement rates, with revenue averaging 82% above those levels.   

Taxpayers could save nearly $260 million, and plan members more than $50 million annually. Nearly 90% of primary care physicians will get a pay increase between 5% and 30%. Mental health providers also will get increases. 

Providers have until July 1 to sign contracts with the State Health Plan. Folwell said he hasn’t received any hospital commitments and is taking N.C. Healthcare Association lobbyists at their word. They said no hospitals would join the network. He declined to speculate what hospitals’ lack of participation would mean for his plan until the contract deadline passes.