New Atrium Health Affordability Protection Program Launched to Ensure North Carolina State Health Plan Members Can Keep the Care They Know and Trust

New Atrium Health Affordability Protection Program Launched to Ensure North Carolina State Health Plan Members Can Keep the Care They Know and Trust

New affordability program makes Atrium Health the lowest cost-share option for enrolled State Health Plan members in North Carolina

CHARLOTTE, N.C., Oct. 6, 2026 - Atrium Health today announced the Atrium Health Affordability Protection Program, a new initiative designed to preserve access, patient choice and affordability for enrolled North Carolina State Health Plan members. This new program is intended to address the higher healthcare costs created for patients seeking care at Atrium Health by the NC State Health Plan's new tiered provider structure. Through the new program, enrolled members will have the lowest copays and lowest overall cost-share for care at any Atrium Health facility or provider - less than any other health system across North Carolina.

When the NC State Health Plan first announced its tiered provider structure, Atrium Health was not included in either the Access Tier or Preferred Tier despite caring for State Health Plan members and their families across North Carolina. Atrium Health submitted several proposals, including an offer to match Preferred Tier pricing so State Health Plan members could continue accessing Atrium Health care at the same cost as other Preferred Tier providers, but those proposals were not accepted by the State Health Plan.

The subsequent agreement announced on September 14 reflects the NC State Health Plan's final decision regarding Atrium Health's participation in the new network structure after collaborative discussions between the organizations. While that agreement preserved access to many important services, including primary care, behavioral health, emergency services, children's hospitals and rural hospitals, NC State Health Plan members would still face higher costs for certain Atrium Health services beginning in 2027 - particularly for specialty care and in communities where Atrium Health hospitals and physicians were assigned to a non-preferred tier. The new Atrium Health Affordability Protection Program is designed to address and eliminate any remaining affordability gap.

"While we can't control the tier designation assigned by the State Health Plan, we can take action to ensure our dedicated public servants across the state are not left to face the consequences of these decisions," said Steve Smoot, president of Advocate Health's North Carolina and Georgia Division, which Atrium Health is a part. "We continue to hear from State Health Plan members who are concerned about higher costs and the possibility of having to change providers, particularly for specialty care. We didn't want our patients to have to choose between the care team they trust and affordability. The Atrium Health Affordability Protection Program is our solution, helping enrolled members continue receiving the care they choose without higher costs standing in the way."

How the New Atrium Health Affordability Protection Program Works

The Atrium Health Affordability Protection Program is a commitment that lowers the cost-share and copays for care enrolled State Health Plan members receive at Atrium Health. Through the program, copays for primary care, specialty care, outpatient and inpatient services will be less than amounts members would otherwise pay under the State Health Plan's Preferred Tier.

"We believe it's our responsibility to do our part to address rising healthcare costs," said Eugene A. Woods, chief executive officer of Advocate Health. "That commitment takes many forms. Last year, nearly 100,000 North Carolina patients received 100% charity care through Atrium Health and never received a bill, and Atrium Health invested $2.38 billion in community benefit across the state. Our new Affordability Protection Program is another step forward - and one more way we're leaning in to help patients and families keep the care they trust while making it more affordable."

For example, an enrolled member in the Standard Plan under the NC State Health Plan's tiered structure receiving outpatient surgical care at a non-preferred facility would face a $1,000 copay, a deductible up to $5,000 for an individual and then 30% coinsurance. Under the new Atrium Health Affordability Protection Program, that cost would be reduced to a $400 copay - saving that member thousands of dollars.

Another example is an enrolled NC State Health Plan member on the Standard Plan receiving inpatient care at one of Atrium Health's urban hospitals under the non-preferred benefit would be responsible for a $1,500 copay, up to a $5,000 deductible and 30% coinsurance under the State Health Plan's tiered provider structure. Under the new Atrium Health Affordability Protection Program, that cost would be reduced to a $500 copay.

"The most important message we want State Health Plan members to hear is simple: we've got your back," added Smoot. "When you select a primary care provider during open enrollment, you can feel confident choosing or keeping an Atrium Health provider. That's because, regardless of how Atrium Health is categorized under the State Health Plan's new structure, the new Atrium Health Affordability Protection Program is designed to ensure members can continue receiving care from Atrium Health at the lowest cost-sharing available under the State Health Plan."

The new Atrium Health Affordability Protection Program will be available to enrolled State Health Plan members beginning January 1, 2027. Additional details regarding eligibility, enrollment and program administration are available via Atrium Health's dedicated State Health Plan Member Education Center.

What Patients and Communities Are Saying

Throughout this process, Atrium Health heard from thousands of North Carolina State Health Plan members who shared a common concern: they did not want to lose access to the Atrium Health physicians and care teams they know and trust. Many described relationships built over years and, in some cases, decades. They spoke about clinicians who compassionately managed complex conditions, guided them through serious diagnoses and stood beside them during some of life's most difficult moments. For these patients and families, healthcare is personal. The relationships they have built with their care teams are not easily replaced.

It is these concerns that led to the creation of the Atrium Health Affordability Protection Program. Since learning about the initiative, community leaders across North Carolina have expressed strong support for how it will help protect teachers, first responders, public servants and their families. From school superintendents to police chiefs and beyond, leaders have welcomed the effort to preserve access to affordable, high-quality care.

• Spencer B. Merriweather III, District Attorney, NC Prosecutorial District 26 (Mecklenburg County)

  "As an employer of dedicated public servants, it is really important to me that my employees maintain healthcare affordability and choice. I am pleased that Atrium Health, on its own initiative, has announced this program today to help ensure my employees can continue receiving care from their chosen provider at an affordable cost." 

• Dr. Melissa Balknight, Acting Superintendent, Charlotte-Mecklenburg Schools

  "Our educators, staff and families depend on access to quality, affordable healthcare providers they know and trust. We appreciate efforts to help preserve access and affordability to important healthcare services for our staff as they continue focusing on supporting student success."

• Dr. Carol Spalding, President, Rowan-Cabarrus Community College

  "The health and well-being of our employees is a priority at Rowan-Cabarrus Community College. We want our employees and their families to have clear information about their State Health Plan options and continued access to their existing providers, so they can stay focused on their health, their work, and the students we serve."

• Dr. John Kopicki, Superintendent, Cabarrus County Schools

  "Access to quality healthcare is important for our employees and the families they serve. We appreciate efforts that help State Health Plan members maintain relationships with trusted healthcare providers while providing clarity as they make important enrollment decisions."

• Crystal Smith, HR Director, Town of Mount Pleasant, NC

  "Access to quality healthcare is important for the employees who serve our community every day and for the families who depend on them. We appreciate efforts that provide clarity for State Health Plan members and help preserve access to trusted healthcare providers and services so employees can make informed healthcare decisions with confidence."

• Dr. Andrew Houlihan, Superintendent, Union County Public Schools

  "Supporting the wellbeing of our employees is essential to helping students succeed. We appreciate efforts that provide clarity for State Health Plan members and help preserve access to trusted healthcare providers and services for the educators, staff and families who strengthen our community every day."

• Dr. Aaron Allen, Superintendent, Lincoln County Schools

  "Atrium Health's new Affordability Protection Program will allow our State Health Plan members to maintain provider patient relationships that are well established. This adjustment in response to the Plan's tiered structure reflects an intentional focus on patient well-being and peace of mind. As an employer of thousands of state employees in a rural county, this move provides relief from a big unknown that has loomed over our community for months. Thank you, Atrium Health."

• Dr. David Shockley, President, Surry Community College

  "Access to trusted healthcare providers is important for the wellbeing of our employees and the communities we serve. We appreciate efforts that provide clarity for State Health Plan members and help preserve access to quality healthcare services so individuals and families can continue receiving the care they need close to home."

• Jenny Varner, President, Davidson-Davie Community College

  "Access to quality healthcare is so important for our employees and the communities we serve. We value efforts that help State Health Plan members understand their options clearly during open enrollment and maintain access to trusted care."

• Dr. Heath Belcher, Superintendent, Davie County Schools

  "Teachers and school employees play a vital role in our community, and access to trusted healthcare providers helps them continue that important work. We appreciate efforts that help preserve continuity of care for State Health Plan members and their families."

• Dr. Mike Rodgers, President, Wilkes Community College

  "Access to high-quality healthcare is important for our employees, their families and the communities we serve. We appreciate efforts that help State Health Plan members maintain access to trusted providers and provide greater confidence as individuals make important healthcare decisions for the future."

For an up-to-date list of quotes from community leaders and organizations, please click here.

About Atrium Health 

Atrium Health is advancing clinical care and research across the communities it serves by redefining care for all. Locations include Atrium Health Carolinas Medical Center in Charlotte, which includes Levine Children's Hospital, Levine Cancer Institute and Sanger Heart & Vascular Institute; and Atrium Health Wake Forest Baptist in Winston-Salem, which includes Brenner Children's Hospital and Atrium Health Wake Forest Baptist Comprehensive Cancer Center. Together, these academic medical centers support a statewide network of 19 hospitals, more than 1,060 care locations serving communities across North Carolina. Atrium Health is also the only health system in North Carolina to receive the American Medical Association's Joy in Medicine™ Gold Level Recognition, reflecting its commitment to supporting clinicians and advancing exceptional patient care. It is part of Charlotte, North Carolina-based Advocate Health, the third-largest nonprofit, integrated health system in the United States. Advocate Health is a preeminent academic health system at the forefront of clinical excellence, innovation and research, with Wake Forest University School of Medicine serving as its academic core. Nationally recognized for expertise in heart and vascular, neurosciences, oncology, pediatrics and rehabilitation, Advocate Health is also a pioneer in the delivery of virtual healthcare. It's accelerating discovery by making research participation part of the standard-of-care through its one-of-a-kind National Center for Clinical Trials. Advocate Health has one of the nation's largest graduate medical education programs, with an experiential learning focus and specialized residencies to help protect the long-term sustainability of rural healthcare in America. Each campus of the school of medicine has an affiliated life-sciences focused innovation district: The Pearl, in Charlotte, and Innovation Quarter, in Winston-Salem, North Carolina. With more than 165,000 teammates serving patients at 69 hospitals and over 1,000 care locations across eight states, Advocate Health reinvests over $6 billion each year to improve community health, making it one of the nation's largest providers of community benefit. In North Carolina, Atrium Health invested $2.38 billion in community benefit in 2025 and is the largest provider of care for Medicaid, uninsured and underserved patients.