(RALEIGH, N.C.) – State Treasurer Dale R. Folwell, CPA, and the State Health Plan (Plan) announced today that Rehabilitation Associates Network (RAN) has endorsed the Clear Pricing Project and its goals of lowering health care costs for the State Health Plan and putting independent practitioners in a better position to compete with large health care providers.
RAN is the largest network of independently private practitioners of physical and occupational therapy operating in North and South Carolina since 1997. The network was formed to assist the private rehabilitation professional in remaining independent in their individual communities by providing the necessary support structure of contracting and credentialing with the different payors of both states.
The Clear Pricing Project (CPP) was announced last year. Under CPP, the Plan will move away from a commercial-based payment model to a reference-based, transparent pricing model tied to Medicare rates. Health care providers will be reimbursed for their services at Medicare rates plus an average of 82 percent.
Under the new network, the Plan will provide increased reimbursement payments to most independent primary care doctors, behavioral health specialists and many rural hospitals. This strategy provides substantial support for those medical professionals that are key health care providers to the Plan's members including groups like RAN. This strategy will also save taxpayers almost $258 million and Plan members almost $57 million.
In a letter to North Carolina State Treasurer Dale R. Folwell, Rick St. George, president of RAN, said, “We applaud your efforts toward reining in health care costs for the state health plan, and endorse and support your Clear Pricing Project. We appreciate your proposal of leveling the playing field between the larger healthcare
providers within the state and the individual private practitioner. This proposal provides a glimmer of hope to the private practitioner that his/her healthcare practice may be able to compete with these larger systems, and continue to provide affordable healthcare solutions to their communities."
Today, Mr. St. George's Charlotte-based St. George Physical Therapy signed the contract to join the North Carolina State Health Plan Network and intends to communicate to the other 60 members of RAN in North Carolina to do the same. St. George added that he was “certain" that all the members will sign within the week and expressed his appreciation to Treasurer Folwell and the Plan for the opportunity.
“We're pleased that RAN has chosen to endorse our efforts to increase transparency, lower costs and push the power to the consumer when purchasing health care," said Treasurer Folwell. “While many medical groups have approached us with enthusiasm, they're one of the first to publicly express support. We are very appreciative and look forward to having them in the North Carolina State Health Plan Network."
Earlier this week, the State Health Plan announced that the Plan's new network-provider contracts had been released and were available for review and signatures. The contract has been posted online and made available for providers to download, sign and submit to Blue Cross NC, the Plan's third-party administrator. Medical providers will have until July 1, 2019 to return their signed contract to be part of the NC State Health Plan Network. Providers that do not return the contract by this date will be considered out-of-network as of January 1, 2020.
Providers should visit www.bluecrossnc.com/providers/ncstatehealthplannetwork for more information. Plan members can find more information regarding the Clear Pricing Project at www.shpnc.org.
The State Health Plan, a division of the N.C. Department of State Treasurer, provides health care coverage to more than 727,000 teachers, state employees, current and former lawmakers, state university and community college personnel and their dependents, including non-Medicare and Medicare retirees.