NC State Health Plan Clear Pricing Project Update

On April 8, 2025, NASW-NC Executive Director Valerie Arendt met with North Carolina State Treasurer Brad Briner and staff from the State Health Plan (SHP) to address the conclusion of the Clear Pricing Project and to reinforce SHP’s commitment to delivering high-quality behavioral health services while continuing efforts to increase provider reimbursement rates. The SHP has asked CPP providers to take the following survey to help with this transition.

Email sent to all current Clear Pricing Project (CPP) providers on April 21, 2025:

The State Health Plan (Plan) would like to extend its sincere gratitude to the providers that have supported the Clear Pricing Project (CPP) by being a part of the N.C. State Health Plan Network. 

The Plan is facing a $507 million deficit which we are actively trying to close. This means evaluating all programs, like CPP, to determine the best way to stabilize the Plan’s financials.

When CPP launched in 2020, the intention was to promote transparent health care pricing, while trying to promote quality primary care and behavioral health. CPP introduced provider reimbursement rates based on a percentage of Medicare with incenting members to visit participating providers by reducing their copay down to zero. Given that most of the providers that signed up for CPP received an increase in reimbursement rates coupled with members having no cost-share, this model has not proven to be financially viable for the Plan.

Given the current financial situation of the Plan, we must find other solutions that benefits all three parties: the Plan, members and providers. As such, the Plan will be ending CPP in its current form as of December 31, 2025.

The Plan is committed to continuing its effort in promoting affordable access to behavioral health services through reimbursement rates and member cost-share; however, it will not be at the current CPP reimbursement rate and will not have a $0 member cost share. 

While the Plan does need to cut costs, we are not willing to compromise on improving member health and recognize this is a balancing act, therefore we are reaching out to the provider community for feedback so we can partner together on something more sustainable for all parties.

Please complete this brief survey by April 25, 2025.

Click here for the survey.

The Plan appreciates your participation and values your opinion as we move forward to determine the best way to serve Plan members while balancing the need to address our financial challenges.