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Reimbursement Rates Paid to Medical Providers: A Tug-of-War in North Carolina
Hill, Chesson & Woody
Apr. 19, 2019 "The [North Carolina State Health Plan (SHP)] is looking for ways to control healthcare cost and it has its eyes set on the reimbursement rates paid to medical providers.... [The SHP] has an estimated unfunded liability of $35 billion leading to potential insolvency by 2023. Currently, medical providers are reimbursed based on negotiated rates, which are set by insurance carriers.... The proposed plan would reimburse healthcare providers at 182% of Medicare reimbursement rates. By making this change, North Carolina could save approximately $300 million per year; and an additional $60 million per year for the approximately 720,000 members with lower out of pocket expenses." MORE >> |
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