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High-quality health care is essential to making North Carolina a competitive place to do business, yet our state’s health outcomes remain well below average — ranking 32nd in the 2021 America’s Health Rankings Annual Report. North Carolina can and must do better if we are to become a top-ten state for health care value. That’s why the NC Chamber is committed to improving our state’s overall competitiveness, and the health of our population, by pushing for a value-driven health care model.

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The Current Challenge

The COVID-19 pandemic shed light on the urgent need for higher-quality health care, health inequities that exist among our communities, and a growing mental health epidemic.

Our state has come to an impasse where our health care structure is no longer working for anyone. It isn’t working for employers who are facing skyrocketing health care costs year after year or for those employees who feel their health care coverage isn’t adequate.

Employers want to provide robust health care plans to their people but are often challenged by budgetary constraints — an issue that has only compounded over the years as health care prices continue to climb. As we come out of this pandemic, the cost of health care and desire to provide employees with high-quality health plans has come to the forefront of employers’ minds — more than ever before.

The Solutions

We cannot allow ourselves to become complacent with the status quo and we must take a more holistic look at health — physical, mental, and emotional. The NC Chamber will encourage our members to begin looking at health care benefits packages through this lens and we will advocate for health care plans that improve overall health outcomes.

As home to RTP, leading research institutions, a dominant insurance carrier, and some of the nation’s top medical systems and pharmaceutical manufacturers, North Carolina has every resource needed to drive change. But organizations need options, as health care solutions are not one-size-fits-all. As we edge out of the pandemic, what better time is there than now to look toward health care options that help protect North Carolinians and allow employers to provide value-driven care at an affordable cost?

That’s why the NC Chamber is advocating to bring value-driven health care to North Carolina in order to improve health outcomes and make costs more predictable and affordable for businesses — with the goal of keeping employees as healthy as possible, reducing instances of chronic disease, and lowering the most expensive health costs, such as hospital visits.

Employers of all sizes want to do right by their people, but right now, particularly for small and even some medium size businesses, health care is frankly unaffordable. As health care costs have increased over time, it has left fewer plan options and smaller provider networks, leaving individuals to pay more for reduced benefits. An Association Health Plan (AHP) allows smaller groups to gain regulatory and economic benefits of a large group plan—enabling them to band together to manage risk and lower costs. This provides businesses with a significant savings when compared to a commercial small group market plan. The NC Chamber supports new legislation that will meaningfully establish association health plans in our state, believing that they provide a valuable and essential coverage option particularly for small businesses who need this health care option to care for their people.

A bill we championed, Exclusive Provider Organization (EPO) benefit plans (SB228/HB373), was signed by Gov. Roy Cooper in September 2021. This bill will help give small and local businesses in North Carolina more choices in providing affordable, high-quality health insurance options to their employees. When employers are better able to manage their health care costs, the healthier North Carolina will be as a state. EPOs also advance North Carolina’s ability to successfully compete with other states to attract businesses.

Another bill that was passed into law in 2021 with the NC Chamber’s support was Allow Vision Service Plans (SB85). Before this bill’s passage, state laws made it difficult for health plans offering just one type of coverage (e.g., dental) to offer additional coverage. Senate Bill 85 streamlines and modernizes these laws to boost our health care competitiveness. It defines any nonprofit corporation offering dental, health, medical, or vision plans as a “hospital service corporation” and enables these entities to provide vision service plans in conjunction with their primary offering.

Certificate of Need (CON)/Threshold Amds. & Certificate Expirations (SB 462) was another bill supported by the NC Chamber and championed last year. CON laws are designed to ensure major expenditures for health care facilities are determined based on community needs. The NC Chamber supports reforming North Carolina’s CON laws to lower costs for health care systems and other job creators while opposing CON’s outright elimination.

Mental Health

The health of people — physical, mental, and emotional — is a top priority for employers, and a chief focus of that has become mental health. While mental illnesses are highly treatable, North Carolina has fallen short in providing a behavioral health system that is accessible and accountable for its outcomes. A 2021 State of Mental Health in America Report by Mental Health America ranked North Carolina 44th among states for access to mental health care. The same report ranked North Carolina 45thin the country for youth mental health. That’s why the NC Chamber is collaborating and beginning conversations with allied organizations such as the North Carolina Health Care Association to find ways to increase awareness of potential policy improvements in that space, as well as connecting employers with tools they can use to support their employees.

In 2022, the NC Chamber launched an employer-focused initiative to provide businesses with resources, best practices, and tools to help address mental health in the workplace. The pandemic has without question exacerbated the existing mental health crisis in our country and state, and employers are seeing the impacts of that every day on their employees. We hope to help the business community navigate this issue—which many health professionals have called ‘the second pandemic.’

The Agenda

  • View our 2023 Legislative Agenda to learn how the NC Chamber will advocate for value-driven health care, with more predictable costs, this legislative session.
  • Learn how the NC Chamber championed health care issues for North Carolina’s businesses in the 2021-2022 edition of How They Voted.
  • Explore our yearly Health Care Conference, which will be held in person in September 2022. Last year’s event took a state-focused look at the urgent need for higher-quality health care,  health inequities that exist among our communities, and our growing mental health epidemic. Speakers also discussed the longstanding changes to health care that will remain as a result of the pandemic and the ability of health IT to impact both the cost and quality of health care.
  • Increase Value and Reduce Costs Related to Health Care: We will advocate for health care plans that improve overall health outcomes for North Carolinians and will always work to give employers options that improve quality and employee health, while still decreasing costs. We also advocate against additional employer health coverage mandates that dictate what health plans must offer; mandates take price sensitivity out of the hands of employers and employees, who in the end, are the ones bearing the cost of health care. Additionally, we are working to advance Certificate of Need (CON) reforms that reduce costs to the health care system and businesses. In our joint effort to reduce costs health care costs and increase value, the NC Chamber Foundation is working to educate the NC Chamber’s 1,000-plus members about high-quality, lower cost plans that work for both them and their employees.