The State Health Plan recently established the four-tier system, which places providers into categories that determine members' copays and deductibles. Preferred providers offer the lowest out-of-pocket costs, while non-preferred providers could result in significantly higher expenses.
WakeMed, one of the Triangle's largest health care providers, said the designation could have major financial consequences for the nonprofit health system.
In a statement, WakeMed spokesperson Kristen Kelly said the decision would affect patient choice and access to care.
"We do not understand why State Health Plan administrators would eliminate patient choice and access to not only a low-cost provider, but Wake County's largest provider," Kelly wrote.
As of Friday, the State Health Plan was still negotiating with Duke Health and WakeMed over which system would be named the state's access provider. Duke Health was ultimately selected for that designation.
According to the State Health Plan, access providers rank just below preferred providers in the network and are expected to remain largely cost-neutral for members.
The State Health Plan's preferred providers include UNC Health and Novant Health.
In a statement, WakeMed's CEO criticized the outcome.
"Every day, teachers, law enforcement officers, firefighters and so many other public servants dedicate their careers to serving North Carolina," said David Zaas, M.D., chief executive officer of Duke Health. "They deserve a health system that is equally committed to serving them."
WakeMed called the decision "extremely dangerous" for the thousands of state employees and teachers who rely on its services.
The changes are scheduled to take effect in January, giving State Health Plan members time to review their coverage and determine whether their health care provider is affected.
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