North Carolina, Duke Health Settle Dispute, Averting Premium Hikes and Ensuring Care
North Carolina and Duke Health have reached a settlement, ending their dispute over employee and retiree healthcare costs on the state health plan. The agreement, involving Duke, Aetna, and the United States, aims to enhance efficiency, maintain high-quality care, and reduce healthcare expenses.
The state health plan, with approximately 23,000 members who primarily use Duke for care and 40,000 who have filed claims this year, was at risk of increased premiums in 2027 due to Duke's demand for higher payments from Aetna. In response, the plan authorized hiring alternative medical providers in case Duke exited the network.
However, the settlement ensures Duke's continued involvement, preventing premium hikes in 2027. It also guarantees ongoing care for current cancer and maternity patients, as required by North Carolina law. The agreement is set to last for multiple years, promoting stability and cost-effectiveness.
State Treasurer Brad Briner, a Republican, expressed gratitude towards Duke for its commitment to keeping costs down. The settlement comes after the state health care plan board raised premiums for 2026 to address a projected $500 million shortfall, with the Legislature providing $100 million in aid this year. The agreement between Duke, Aetna, and the United States ensures affordable healthcare for plan members while maintaining quality care.
