East Carolina University Physicians signed a contract to join the North Carolina State Health plan at the end of June, one week before the July 1 deadline, which is expected to have a positive financial impact on the practice and continue to support the state employees.
ECU Physicians is the medical practice of the Brody School of Medicine and is dedicated to providing superior patient care and improving the region’s health, according to the official ECU Physicians website. The medical practice is the “largest and most comprehensive” in the eastern North Carolina region.
Mark Stacy, dean of the Brody School of Medicine, said the main reason the university joined the NC State Health Plan network was because ECU Physicians are University of North Carolina (UNC) employees which means they will be covered by the plan.
“We have a responsibility to care for people who work for the state of North Carolina and we exercise that responsibility,” Stacy said. “It would be a hardship for people who work in the county or the people who work at ECU to have to seek, to have to change their providers because we did not want to be a part of the state health plan.”
Stacy said the plan will allow ECU Physicians to continue to care for patients who are covered in the NC State Health plan if they continue to seek care and treatment through the medical practice.
The plan will go into effect on Jan. 1, 2020. According to Stacy, there may be an increase in individuals who seek care through ECU Physicians next year since they have joined the state health plan. He said, in comparison to last year’s numbers, by joining the NC State Health Plan the practice will gain income and “fair better” financially than it did in 2018.
“From a business standpoint, it made good sense for a multi-specialty practice to accept this state health plan this year,” Stacy said. “It doesn’t make as much sense for a hospital to do that because the hospital reimbursement is very likely to decline drastically while reimbursement for primary care is expected to increase a little bit.”
Vidant Medical Center did not sign on to join State Treasurer Dale Folewell’s proposed NC State Health Plan network.
Stacy said people have been following along with the NC State Health Plan for most of the year, but his interests increased within the six weeks before the contract was signed. He said the university had to wait until the plan matured to the point where the terms and language of the contract could be understood.
“I worked closely with (Interim) Chancellor Gerlach and we worked closely with the system office to talk through the reasons that we thought this was the most appropriate thing for us (ECU) to do at this time,” Stacy said. “And so we made a decision together.”
Brian Jowers, the executive director of ECU Physicians, said the benefits the NC State Health Plan will provide for the practice are positive. He said when looking into signing on, numbers from the 2018-2019 fiscal year were compared.
Jowers said by signing on to the state treasurer’s state health plan, the generated revenue by ECU Physicians will most likely be “the same” as it has been in the past previous years or slightly increased. He said joining the plan wasn’t viewed as a source to gain revenue.
“We were looking at it mainly because we wanted to continue to take care of our own people. The people that are working for us and the people that are working for the state of North Carolina,” Jowers said. “The fact that it’s pretty much a break-even for us, and it is five million dollars worth of our business we thought, well there’s no reason why we wouldn’t do this.”
Jowers said there were sessions in Raleigh which ECU Physicians were able to attend and hear directly from the state treasurer about the NC State Health Plan. He said ECU Physicians was able to review the contract in advance and have discussions with the treasurer’s office and Blue Cross Blue Shield about language in the contract and were able to make changes to it.
Jowers said he believed ECU signing on to the NC State Health Plan was the right direction for the university and he was happy about it. He said he pushed for the contract to be signed.
“Our job at ECU Physicians is to take care of patients. We’re a practice of about 500 providers and we take care of about 650,000 patients a year in the 29 county region. A lot of those are state health plan patients,” Jowers said. “They are people who work for the state of North Carolina, they work for East Carolina University, and we wanted to make sure we continued to take care of those people.
In a statement released by the UNC System, Interim President Bill Roper addressed the NC State Health Plan and its effects on teachers and state employees.
“The North Carolina State Health Plan for Teachers’ and State Employees (“State Health Plan”) is currently working to establish its own health care provider network along with a new approach in how providers, such as doctors and hospitals, are reimbursed for covered medical services,” according to the press release.
If ECU had not signed on to the NC State Health Plan before the deadline ECU Physicians would have been considered an “out-of-network” provider, which would have led to higher out-of-pocket costs for state employees and dependents covered by the state health plan, according to the press release.