Guest columnist: Policymakers must partner with health experts

Published 12:01 am Sunday, March 10, 2019

By Carl S. Armato

As the president and CEO of Novant Health, I have been following the ongoing conversation related to the North Carolina State Health Plan with great interest.

However, after reading the opinion piece by State Treasurer Dale Folwell published Feb. 24 (“State health plan changes will provide transparency”), I can no longer sit on the sidelines of this conversation. I have to get on the field for Novant Health’s 28,000 team members and the over 700,000 beneficiaries of the State Health Plan.

I was taken aback by the treasurer’s unsubstantiated claim that, if hospital reimbursements are reduced for State Health Plan-covered patients, we (hospitals) would unnecessarily order more tests to make up the loss in income. This could not be further from the truth.

At Novant Health, our top priority is our commitment to our patients. Our team members wake up every single day focused on ensuring our organization provides high-quality care that is centered on keeping people healthy while reducing costs. It’s what our patients, many of whom are teachers and state employees, deserve. The claim that these dedicated health care professionals would order unnecessary tests is contrary to the very mission of our organization.

In fact, Novant Health has been finding innovative ways to take costs out of health care for more than a decade. We have proven that by focusing on improving people’s health you can lower costs. We started with our team members and, after achieving great results, now participate in a value-based care program for nearly 80,000 people. Novant Health demonstrated significant reductions in the cost of their care — over $17 million in savings in a single year. More important, we improved the health of those nearly 80,000 people and we stand ready to help any employer, including state government, achieve similar results.

How do we do this? Instead of simply focusing on people when they are sick, we focus on keeping them well through care coordinators who identify gaps in the patient’s care and encourage reconnection with their doctors. If people don’t have a primary care provider, we help them get one. And because an unmanaged chronic condition such as high blood pressure or diabetes can drive up costs, we help patients identify these conditions early and learn to manage them before they require emergency treatment.

We’ve also taken steps to increase transparency by offering financial navigators who help patients estimate health care costs before they receive care. We’ve reduced readmission rates by following up with patients after they leave the hospital to review their care plan, ensure medications are filled and taken and address social needs.

It was also alarming to read the claim the rate reduction Folwell proposes will include a 77 percent profit for health care systems because, on average, providers will be paid 177 percent of Medicare rates. Medicare does not reimburse providers 100 percent of what it costs to provide care. Therefore, the treasurer’s math is inaccurate. As a not-for-profit health care system, all excess income over and above the cost of keeping our doors open, including caring for those who cannot pay, is reinvested in our people and in ways to improve the health of our communities.

Health care is expensive and more transparency is needed, but rate reductions alone do not achieve better health or better value. It is critically important for the health of our State Health Plan participants that policymakers partner with health care experts to develop a better solution. This is exactly what state Rep. Josh Dobson is seeking to do with his recently introduced legislation. Dobson’s bipartisan bill proposes to bring together experts to design the best possible plan for state employees — one that cuts costs while improving health.

I am hopeful Rep. Dobson is successful and that Novant Health can use our experience and expertise to sit at the table with others to design a State Health Plan that lowers cost and improves the health of state employees including teachers, retirees and their families. I think they deserve both lower costs and better health. Don’t you?

Carl S. Armato is president and CEO of Novant Health.