Atrium agreement expands State Health Plan access for 2027
Twelve Atrium Health hospitals and associated clinics will enter the plan’s Access tier, while protections will continue for primary, behavioral, emergency and complex care.
RALEIGH — Twelve Atrium Health hospitals and associated clinics will join the North Carolina State Health Plan’s Access tier in 2027 under an agreement announced Monday by the plan and the health system.
The agreement addresses concerns about how the plan’s new tiered provider network could affect teachers, state employees, retirees and their dependents who receive care through Atrium.
The State Health Plan, which is administered by the Department of State Treasurer, provides coverage to nearly 750,000 members.
Beginning Jan. 1, Atrium rural hospitals in Alleghany, Anson, Cleveland, Columbus, Lincoln, Scotland, Stanly and Wilkes counties will receive Access-tier treatment. The group includes Atrium facilities in Shelby and Kings Mountain and Hugh Chatham Health.
Levine Children’s Hospital in Charlotte, Jeff Gordon Children’s Hospital in Concord and Brenner Children’s Hospital in the Triad will also enter the Access tier.
The plan said members who use an Atrium primary care provider may continue that care without a change in cost or benefits. The same protection will apply to behavioral health office visits and emergency care.
Members receiving complex services that may not be readily available elsewhere—including certain cancer, cystic fibrosis, cardiac and transplant treatments—will remain eligible for Atrium care. Pregnant members will not be required to change existing obstetricians or delivery arrangements for 2027, according to the announcement.
The plan and Atrium said they are continuing to refine the list of benefit exceptions before open enrollment. Members who qualify for continuity protections will receive notices from the plan.
State Treasurer Brad Briner said the agreement includes affordability commitments from Atrium, but the release did not disclose reimbursement rates, projected savings or other financial terms.
The announcement follows negotiations that began in mid-July. State legislators also participated in discussions and hosted meetings involving plan officials and members.
The agreement does not place every Atrium facility in the highest-benefit tier. Members should consult the final 2027 hospital-tier list and their plan documents before scheduling nonemergency care.
Editor’s note:
This article was drafted with the assistance of artificial intelligence and was reviewed and fact-checked by a member of the NC Political News editorial team before publication.
