State Health Plan Board Approves 1st Phase Of Preferred Provider Strategy

Votes taken by the State Health Plan (Plan) Board of Trustees yesterday aim to improve health outcomes for members while also considering cost transparency and long-term affordability. The trustees approved contracts with three clinically integrated networks (CINs): Aledade, Community Care Physician Network and UNC Health Alliance. These agreements represent the first phase of the Plan's new preferred provider strategy.

"In 2025, we had a revenue problem. In 2026, we have a cost problem," said Treasurer Brad Briner, who chairs the Board of Trustees. "This preferred provider strategy is one of the tools we are using to confront that challenge head-on - by rewarding quality, improving coordination of care and bending the cost curve in a way that aims to protect our members."

By partnering with clinically integrated networks that have proven quality and performance as well as cost transparency, the goal is for member health to improve and costs for the Plan to go down. Plan members also benefit from lower co-pays for preferred providers. There are approximately 4,500 providers throughout North Carolina in these CINs.

"As the state's Health Care System, UNC Health and UNC Health Alliance are proud to partner with the N.C. State Health Plan in expanding affordable access to exceptional care throughout North Carolina. Central to this mission is strengthening our primary care network, particularly in underserved rural communities, where we remain deeply committed to making a difference. Together we're working to ensure all North Carolinians receive the quality care they deserve," said Dr. Mark Gwynne, UNC Health Chief Value Officer.

Right now, many of North Carolina's smaller - and often rural - providers face administrative burdens like processing prior authorizations and time-consuming claims processes. Their time is better spent delivering care. These contracts include supports meant to lessen those burdens and place their efforts more towards patients.

"I applaud the efforts of Treasurer Briner and State Health Plan leadership to reduce the administrative burdens, like prior authorization, on physicians and providers across the state," said Rep. Tim Reeder, a physician representing Pitt County in the legislature. "Efforts that improve health through innovative strategies are not only great for patients but also strengthen the Plan."

"This is a win for state employees, health care providers and taxpayers in North Carolina," said Sen. Benton Sawrey, who represents Johnston County in the legislature and serves as the Senate Health Care Committee chair. "Anything we can do to deliver better results at an affordable cost is a great outcome for all of North Carolina. I look forward to seeing the preferred provider strategy rolled out and expanded over the next several years."

"This effort shows that investing in independent primary care is a win-win for North Carolina physicians and state employees - demonstrating that incentivizing preventive care keeps employees healthy, ensures access to care statewide and saves money for the system in the long run," said Alex Mullineaux, Aledade North Carolina Market President. "Aledade is proud to support this innovative approach and hopes it can serve as a model for others looking to make the system work better for all of us."

"Community Care of North Carolina's advocacy for community-based primary care aligns with the value-based program the State Health Plan has proposed to support front-line medical homes in North Carolina. We strongly believe that community-based primary care led by independent clinicians is the best and highest-value approach for the Plan going forward to best serve its members across the state," said Tom Wroth, MD CEO, Community Care of North Carolina, Inc.

Additional phases of the preferred provider strategy are expected to be considered by the Board in the future as the Plan continues to expand access to high-quality, cost-effective care statewide.

Materials from the board and recording of the meeting are located on the Plan's website.

Related Topics: