Blue Cross Blue Shield of North Carolina will resume management of the State Health Plan \u2014 and a separate pharmaceutical benefits contract \u2014 returning to what had been the status quo for decades until 2023, when the board voted to shift management to Aetna.<\/p>\n
Some health plan members had voiced complaints about Aetna. And earlier this year, Republican State Treasurer Brad Briner indicated he was ready for a change. The treasurer oversees the Health Plan.\u00a0The change, approved by the health plan board on Friday, is set to take place in 2028.<\/p>\n
The switch back to Blue Cross could affect prices health plan members pay, services that are covered and which providers are considered in-network.<\/p>\n
“Blue Cross brings deep experience, improved capabilities, and a shared commitment to delivering better value and a better experience for people,” Briner said.<\/p>\n
Blue Cross Vice President Roy Watson said Friday, at a press conference with Briner, that “we are committed to working together with the state, provider partners, hospitals, members, and healthcare to make sure that healthcare is more affordable for all in the months ahead.”<\/p>\n
The 2023 decision to switch to Aetna happened under former Treasurer Dale Folwell. \u201cThis administration has different priorities and would prefer a contract that is more in line with those priorities,” Briner spokesperson Loretta Boniti told WRAL in March<\/a>.<\/p>\n An Aetna spokesman said Friday that the company continues to believe it is the strongest partner for the State Health Plan.\u00a0<\/p>\n \u201cOur expertise\u202fand service\u202fhave helped the State Health Plan\u202fto\u202fadvance its cost containment goals, successfully implement\u202fthe Plan\u2019s complex provider tiering strategy, and provide members access to high-quality care,\u201d Phil Blando, the Aetna spokesman, said in a statement. \u201cAetna has been a\u202ftrusted partner in North Carolina for decades, and that commitment remains steadfast\u202fin continuing to support the Plan and its members through the end of the current contract.\u201d<\/p>\n The Aetna contract ends at the end of 2027. The value of the new BCBS contract could fluctuate but is expected to cost the state roughly $12 billion over the next three years, which Briner said would represent a savings of about $1 billion to the State Health Plan.<\/p>\n The decision to switch to Aetna three years ago was a contentious call that led to legal battles<\/a>. Aetna prevailed<\/a> and was awarded the multibillion-dollar contract. It\u2019s possible the decision to back to Blue Cross could lead to similar legal wrangling.\u00a0<\/p>\n “We will review this decision in the coming weeks and decide how best to move forward,\u201d\u00a0Blando said.<\/p>\n