North Carolina state employees, retirees, and their families can now access surgeries at no cost, thanks to a new partnership between the state and Novant Health, teamed up with Lantern, a healthcare services provider.
Last summer, the N.C. State Health Plan (SHP) linked up with Lantern to create surgical programs. After reviewing various local healthcare providers, Novant Health in Winston-Salem was chosen. As the state’s second-largest healthcare system, Novant has a strong presence, especially in the Triad, Charlotte, and Wilmington areas.
Currently, around 750,000 people are enrolled in the SHP, with many members based in the Triangle, where Novant has limited locations. Lantern plans to announce a partnership with another healthcare system in the Raleigh-Durham area shortly. This step is crucial as major players like Duke University, UNC Health, and WakeMed dominate the surgical market in Triangle.
Recent projections indicated a potential $507 million loss for the SHP in 2026, and previous initiatives by former State Treasurer Dale Folwell to reduce hospital charges were unsuccessful. In response, current State Treasurer Brad Briner has increased deductibles and monthly premiums to stabilize the plan.
As Lantern’s President Dickon Waterfield explains, U.S. healthcare costs are exceptionally high, with large employers often billed around $45,000 for surgeries. In contrast, Medicare charges only about $17,000 for similar procedures. Lantern aims to set prices lower than $45,000 but higher than $17,000, hoping to secure the necessary savings to support the SHP.
Tens of thousands of SHP members undergo surgeries each year but often face financial challenges. Thomas Friedman, the SHP’s executive administrator, noted that out-of-pocket costs typically range from $5,000 to $10,000, which can be a significant portion of their salaries. Many members also struggle to find time to research the best surgeons.
This program creates a focused network of highly qualified surgeons. While selected Novant surgeons will be part of this network, SHP members have the choice to seek other options.
Similar plans have been launched in states like Alaska and Florida, but Waterfield believes North Carolina’s initiative will grow quickly due to strong state support. Presently, government employees account for about 30% of the 12 million individuals accessing Lantern’s services.
Lantern, founded about 15 years ago and known as Employer Direct Healthcare until its rebranding in 2024, recently secured $92 million in funding. This financial boost brings its valuation to $1 billion, with notable investors, including Tom Dundon, owner of the Carolina Hurricanes.
Novant’s Chief Medical Officer, Pam Oliver, expressed that this collaboration aims to enhance access and care for the communities they serve. The program covers various surgical specialties, such as orthopedics and vascular care.
As of now, nearly 1,900 SHP members have signed up since the program started last fall, with around 378 having completed surgeries.
For more information on innovative healthcare solutions, check the Centers for Medicare & Medicaid Services here.
