Treasurer continues push on health costs
BY AMELIA HARPER
Thursday, January 10, 2019
While the federal government is working to increase hospital transparency regarding charges, State Treasurer Dale Folwell is calling for more transparency regarding health care contracts with insurance companies as well.
In late November, Folwell called for the U.S. Department of Justice to take action and for all North Carolina hospitals to become more transparent in their pricing. The announcement was made in light of the recent settlement of a lawsuit filed by the U.S. Department of Justice and the state Department of Justice against Atrium Health, formerly known as Carolinas Healthcare System, according to a press release from Folwell’s office.
The civil antitrust lawsuit challenged provisions in Atrium's contracts with major health insurers including Blue Cross and Blue Shield of North Carolina that prohibited what otherwise would have been used to direct consumers toward high-quality, cost-effective health care providers, Folwell said. Atrium was slated to form a joint operating company with UNC Health Care last year, but that deal was derailed in March when both parties could not agree to terms of the contract.
“For decades, the largest public hospital system in North Carolina has been engaging in this and other anti-competitive activities," Folwell said. “In the spirit of this settlement, I'm calling on all North Carolina hospitals to be transparent and to publish their pricing so consumers can make informed decisions regarding health care. I'm also calling for the United States Department of Justice and the North Carolina Department of Justice, on behalf of the State Health Plan, to recover the potentially hundreds of millions overcharged to consumers by hospital management from this illegal activity."
According to the press release, early last year the State Health Plan submitted a public records request to UNC Health Care for a copy of its contract and fee schedule with Blue Cross NC. Blue Cross NC is the third party administrator for the plan and negotiates pricing for its 727,000 members, including teachers in the state. In response, UNC Health Care provided more than 100 pages of redacted information with no visible prices, the release said.
The state-owned hospital said that such pricing information is confidential. Folwell disagrees.
“The taxpayers need to understand that the state treasurer cannot find out from the state hospital what the State Health Plan is paying for medical services for state workers," said Folwell. “It's beyond belief."
Folwell said in the release that after his legal team reviews the settlement, he will be submitting comments on the proposed settlement to the U.S. Department of Justice.
“We're doing what's necessary at this point in our state's history because others didn't," Folwell said. “As chaotic as health care is, we have not lost our commitment on focusing all of our attention on the members and taxpayers like them. It's not enough to just point out problems, ultimately they have to be fixed."
In an interview with the Telegram in March 2018, shortly after the Atrium deal ended, Folwell said he was working to better educate people in the state about the health care plan. He said he also was seeking greater transparency regarding costs so that consumers can make better-informed decisions that will save money for themselves — and the state — in the long run.
Increased transparency can eventually draw medical tourism to areas of the state that offer better health care value, he said. And the increased competition for these services should help drive health care costs down, Folwell said in the interview.
“Consumers want to make medical decisions based on quality, affordability and accessibility. We simply want to put that power in the hands of the people,” Folwell told the Telegram.