Settlement reached for state health plan, Duke Health

(The Center Square) – The state of North Carolina and Duke Health have settled their dispute over the cost of care for employees and retirees on the state health plan, both parties announced Friday.

Details of the settlement were not disclosed but the agreement will not force the state to raise health care premiums in 2027, Loretta Boniti, spokeswoman for the state treasurer’s office, told The Center Square.

The board that governs the health care plan has already raised premiums for 2026 in an effort to erase a projected $500 million shortfall. The Legislature also appropriated $100 million for the health plan this year.

In contract negotiations with Aetna, which manages the state’s health care plan, Duke was seeking increased payments for services which would have caused the state to increase premiums again in 2027, according to the state.

About 23,000 members of the health insurance plan have Duke as their primary care provider and 40,000 have filed a claim with Duke for medical services this year.

Under North Carolina law, if Duke left the insurance network, it would be required to continue to provide care for current cancer and maternity patients, the state said.

The health insurance last week authorized hiring contract medical providers for the other members of the state health plan served by Duke in the event that it left the North Carolina network.

On Friday, Duke, Aetna and the state announced that they had reached a multi-year agreement.

“Throughout this negotiation, we have remained committed to our nonprofit mission of serving the best interests of our patients and community,” Thomas Owens, executive vice president and Chief Operating Officer of Duke University Health System, said in a statement. “We came to the table together to reach an agreement that covers the cost of care. Our agreement with Aetna prioritizes efficiency, promotes high quality care and helps drive down health care costs."

First-term Republican state Treasurer Brad Briner thanked Duke for taking steps to keep costs down.

“We have worked hard to dig ourselves out of a massive deficit and needed the help from all providers in the state to get that done,” Briner said in a statement. “This deal represents Duke’s commitment to serve North Carolina and our members.”