For Immediate Release
Media Contact: Melanie Mozes, North Carolina Provider Owned Plans, 984-349-5777
Eleven Leading North Carolina Health Systems Finalize Provider-Led and Owned Plan to Serve North Carolina Medicaid Program
Raleigh, N.C. – North Carolina’s leading health systems have formalized their partnership intending to bid to serve North Carolina’s Medicaid population through North Carolina Provider Owned Plans, Inc. NC Provider Owned Plans, owned by 11 North Carolina not-for-profit health systems known as Provider-Led and Patient-Centered Care (PLPCC) and Presbyterian Healthcare Services, was formed to support the state’s goal to transform the Medicaid system to a program that provides budget predictability for taxpayers while ensuring access to quality care for those in need.
By collaborating through a statewide provider-owned health plan, the 11 health systems can continue to act in the best clinical interests of the patients they treat every day, while at the same time coordinating care and administrative functions through the size and scope that come with a statewide network.
“While each institution has always worked to help their local residents and patients, this is a critical time for all of these systems to join together in the shared interest and benefit of patients served by Medicaid as well as with independent health care providers across the state,” explains Mike Steiner, M.D., physician at University of North Carolina-Chapel Hill and co-chair of the plan’s physician council.
His thoughts are echoed by his fellow co-chair Dev Sangvai, M.D. with Duke University Health System.
“This effort represents the best of North Carolina’s collaborative spirit,” explained Dr. Sangvai. “By working together to create a Medicaid plan, the leading health systems in the state have demonstrated their commitment to North Carolina. NC Provider Owned Plans will optimize the health of those we serve while maximizing value through provider led innovation and best practices.”
NC Provider Owned Plans will be a first-of-its-kind model for North Carolina, but the impact of provider owned plans is recognized nationally. According to a recent study by J.D. Power, members served by a provider-owned plan are more likely to be satisfied with their health plan than members of a traditional insurer.
“Provider owned health plans have long been recognized for their unique approach to meeting the needs of members. The ownership of our provider owned plan directly aligns accountability for cost, quality and patient experience outcomes with local care providers,” said Lisa Farrell, president and CEO of the NC Provider Owned Plans. Farrell brings over 20 years of provider owned plan experience to the plan.
The health systems span the entire state with their facility and physician office locations:
- Cape Fear Valley Health System
- Carolinas Healthcare System
- Cone Health
- Duke University Health System
- Mission Health System
- New Hanover Regional Medical Center
- Novant Health
- University of North Carolina Health Care
- Vidant Health
- Wake Forest Baptist Medical Center
- WakeMed Health and Hospitals
The health systems’ plan partner, Presbyterian Healthcare Services, has over 30 years experience operating provider-owned plans and is the only plan in New Mexico to have served continuously as a Medicaid managed care plan since the inception of the state’s managed Medicaid program in 1997. Today, Presbyterian serves traditional Medicaid and expansion populations providing a broad range of services including physical health, behavioral health and long term care. Presbyterian will provide core services to NC Provider-Owned Plans as well as lend its expertise in integrating managed care with health care delivery.“
By bringing this type of plan to North Carolina, we can begin to collaborate with physicians and other health care providers to leverage the great work occurring across the state to design innovative care models and programs,” said Farrell.
The plan has filed for an insurance license and will begin actively engaging health care providers across the state in the design of programs that improve health while lowering costs.
About North Carolina Provider Owned Plans
North Carolina Provider Owned Plans is a collaboration of eleven North Carolina health systems formed to develop a provider-led Medicaid Prepaid Health Plan. NC Provider Owned Plans supports the state’s goal to transform the current Medicaid system to a program that provides budget predictability for taxpayers while ensuring access to quality care for those in need.
About Provider-Led and Patient-Centered Care, LLC
Provider-Led and Patient-Centered Care (PLPCC), LLC is a collaboration of eleven North Carolina health systems formed to develop a provider-led and owned Medicaid health plan. North Carolina’s prominent healthcare systems recognize that serving Medicaid patients is a core part of their collective mission. Forming a provider-led plan is a concrete demonstration of their commitment to the long-term health of Medicaid patients, and to the long-term stability of the Medicaid program in the State.
About Presbyterian Healthcare Services
Presbyterian Healthcare Services exists to improve the health of patients, members and the communities we serve. Presbyterian is a not-for-profit healthcare system of eight hospitals, a statewide health plan and a growing multi-specialty medical group. Presbyterian brings 30 years of managed care experience in an integrated system to partner with providers across the country seeking to start or strengthen their own provider-led health plans through its Fluent Health business.