Problems facing the plan
Folwell said the health care plan serves 720,000 individuals, which is almost as many people as the workforces of Amazon, J.P. Morgan and Berkshire Hathaway combined.
“You should be outraged at the fact that you’re involved with a plan which is the largest purchaser of something in this state, not just health care but pharmaceuticals, and we’re not getting the best possible prices,” Folwell said.
Folwell said the state health plan is going to run out of money in 2 ½ years. He said health care and pharmaceutical costs are increasing by more than 4 percent, while the funding in the budget remains at a 4 percent rate.
He said it is unclear to consumers what the money from the budget is actually being spent on.
“No one wants you to know what the price of health care is,” Folwell said.
The problems at hand are not new problems, Matthew Brody, senior vice president of UNC-system Human Resources, said. He said the issues of increasing out-of-pocket costs, extremely high dependent premiums and artificially low individual coverage have been ongoing for several years.
Brody wants to ensure that employees do not get caught in the middle of the state's attempt to solve these problems.
“I’ve heard from many employees over the last few months, as this effort around the clear pricing and the state health plan network have come to the floor, that employees are very concerned," Brody said. "We’ve had folks being very scared about losing access to long-trusted providers, and then all of a sudden being out of network."
Throughout the panel, possible solutions arose.
“In general, partnering with big systems and hospitals in competitive markets around the idea that they want to be committed to total cost and care redemptions, or at least a budget, where they can save money if they come under the budget, where they can gain if they do better or sharing the losses if they don’t," Aaron McKethan, a senior policy fellow at Duke-Margolis Center for Health Policy, said. "That’s been going on and happening nationally with some really good results to show.”
Dr. Matt Ewend, president of UNC Physicians and the chief quality and value officer for the University of North Carolina Health Care System, said the only way to bend the cost curve of health care is to make everyone healthier, while putting more effort into prevention instead of trying to fix things once they have gone wrong.
“I think the key to this is partnership between all the parties,” Brody said. “Between the employers who have employees covered by these plans, between plan administrators and between our health care providers: our local physicians, our hospitals and health care systems. We’re all going to need to work together to figure this out, and we need to get this figured out in a way that doesn’t end up affecting our employees in a very negative way.”
In the meantime, open enrollment is going to start on Nov. 2 and will exist for 17 or 18 days, Folwell said. It will be simpler than it used to be, while not compromising the amount of choices that employees have in the process, Brody said.
“There are no guarantees, but I do not see that we’re going to reach the end of next year and somehow three quarters of the major health systems in the state of North Carolina are not going to be in network for 720,000 people,” Brody said. “So I am optimistic. I’ve told folks not to panic.”