Atrium Health program aims to lower 2027 costs for NC State Health Plan members
Atrium says the program will cut copays for enrolled members receiving primary, specialty, outpatient and inpatient care through its hospitals and providers.
- On Tuesday, Atrium Health announced the Affordability Protection Program, launching January 1, 2027, for nearly 750,000 North Carolina State Health Plan members following exclusion from preferred tier designations.
- New State Health Plan tier designations excluded the Charlotte-headquartered system, prompting Atrium officials to create the initiative addressing member concerns about higher out-of-pocket costs and potential provider changes.
- The program aims to reduce a $1,000 outpatient surgery copay to $500, while inpatient care members otherwise facing a $1,500 copay, up to $5,000 deductible, and 30% coinsurance receive relief.
- State Treasurer Brad Briner criticized the proposal as "greed," questioning its legality and warning it could bankrupt the State Health Plan and threaten the state's credit rating.
- The treasurer's office is conducting a legal review as open enrollment runs next week through October 30, while the State Health Plan and Retiree Health Benefit Fund reported $21.95 billion liability as of June 30, 2025.
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14 Articles
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Atrium Health’s plan contested by state treasurer for legality
(The Center Square) – Nearly 750,000 teachers, state employees, retirees, lawmakers active and retired, and members of higher education on Tuesday learned Atrium Health’s Affordability Protection Program would help provide the lowest copays and overall cost-share at Atrium Health facilities…
NC treasurer: Atrium affordability program could bankrupt state employees’ health plan
Key Takeaways: By Michelle Crouch Atrium Health announced a program Tuesday that aims to lower out-of-pocket costs for members of the health insurance plan for state employees who want to keep their Atrium doctors. But the announcement drew a blistering response from state officials who called it “trickery” that would ultimately cost plan members and […]
Analysts: Atrium affordability proposal spurs more questions than answers
"By undercutting the competition, the hope could be to increase market share so much that it forces the State Health Plan to give them a better deal in the future," said Zagros Madjd-Sadjadi, economics professor at Winston-Salem State University.
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