North & South Carolina | Fall | 2010 | Health Plan Analysis
The recent renewal cycle was especially challenging for employers in the Carolinas, owing to the poor economy and new requirements under federal healthcare reform. Carriers continued to increase copays and coinsurance to slow the healthcare cost trend, but as premiums continue to rise, insurers may begin to look at alternatives such as narrow networks. The Blue plans in North and South Carolina, meanwhile, are expanding the number of patient-centered medical homes for their members. Results from a yearlong study of a medical home in Charleston, S.C., revealed medical and pharmacy cost savings and reductions in hospitalizations and emergency-room visits for participants.
Seeing an influx of new Medicaid beneficiaries, South Carolina has requested approval from the Center for Medicare & Medicaid Services to make it mandatory for most recipients to move to managed care. The program is also making benefit cuts, including a reduction in the allowed number of prescriptions each month, and says provider payments could end in the spring if the agency can't run a deficit or make additional cuts.
