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State Health Plan Targets Health Care and Cost Savings in New Pilot Initiative
Plan Partners with Regional Health Care Providers to Improve Member Care, Achieve Better Health Outcomes and Manage Costs for Plan Members
RALEIGH, N.C.–State Treasurer Janet Cowell announced today that the State Health Plan for Teachers and State Employees is partnering with  three in-state health care systems on a two-year Patient-Centered Medical Home (PCMH) pilot.  The pilot initiative is designed to engage physicians in the care of Plan members, improve member experience and outcomes and ultimately impact healthcare costs.
“Our goal is to improve members’ health and the quality and affordability of the care they receive,” said Cowell. “Public private partnerships like the one between the State Health Plan and these local health care providers help us to better achieve our goal.”
A PCMH is a provider’s office that has received special recognition for efficient, coordinated, high quality care centered on the patient. By developing a long-term relationship with a patient, a PCMH becomes the hub of that patient’s health care.
Specifically, the pilot utilizes a tiered approach in the payment of per member per month care fees to providers who meet specified infrastructural and quality standards with the opportunity to increase the payment over time by continuing to improve select clinical quality of care metrics. A unique feature of this pilot is the use of a collaborative approach with each health care system to identify opportunities for improvement and innovative solutions.
The initiative supports the Plan’s strategic priorities of improving member health and ensuring a financially stable Plan.  The Plan worked with its Population Health Management Vendor, Active Health Management, in the development of this initiative.
The health care systems for this pilot project include the following practices:
  • CaroMont Health in Gaston and Mecklenburg counties
  • Eagle Physicians and Associates in Guilford County
  • New Hanover Medical Group, NHRMC Physician Group in New Hanover, Brunswick and Pender
The pilot initiative began on May 1, 2015.
The self-insured State Health Plan provides health care coverage to more than 680,000 teachers, state employees, retirees, current and former lawmakers, state university and community college personnel, and their dependents. The Plan is a division of the Department of State Treasurer.