Why Lantern is a Key Part of the North Carolina State Health Plan’s Strategy

The North Carolina State Health Plan (SHP) made headlines in December when leaders announced that it’s back in the black after projecting a $1.3 billion deficit in 2027. The Plan says it’s now about $30 million above its reserve rate. Lantern is proud to be a key part of the Plan’s cost-saving strategy.

Tom Friedman, executive administrator of SHP, set out to save both the plan and its members money, knowing that they would need to raise premiums. They wanted to ensure that high-quality care remained affordable.

Here’s what he had to say in the Carolina Journal about how Lantern fits into their strategy:

Friedman stressed that future cost growth will be contingent on how successful they are at steering people to lower-cost settings of care, and that will take some time.

One of those ways is by using Lantern, a digital specialty care platform. The  agreement approved by the board earlier this year with Lantern offers  members no‑cost access to a vetted network of surgeons and specialists. Lantern also provides personalized support through dedicated care advocates and nurse navigators, while helping control costs for both members and the plan.

“The more folks that get surgeries through Lantern, the lower future cost growth increases are going to be because we’re paying less money for it, and I would tell you the state employees have been fantastic partners that help us do that,” he told reporters. “We already have over 200 cases before the program even starts in earnest in January, so we’re making tremendous progress in terms of addressing unit costs, and we’re going to continue to push on those things.”

Lantern helps clients save money by dramatically reducing the cost of surgery without compromising quality. Through direct contracting and a highly selective Network of Excellence, Lantern negotiates rates that are 55% or more below traditional carrier prices, resulting in significant hard-dollar savings on surgeries. For example, spine surgeries through Lantern in North Carolina cost 61% less compared with the average carrier cost.

These savings are amplified by shifting care to optimized sites, such as ambulatory surgical centers instead of hospitals. Plus, clients also see soft-dollar savings related to reduced complications and avoided surgeries, thanks to the experienced surgeons in Lantern’s Network of Excellence.

Like Friedman noted, the more people use Lantern instead of higher-cost care, the more savings clients see. Thanks to Lantern’s local network, utilization is 8x greater compared to traditional COE models.

Congratulations to the North Carolina State Health Plan on the progress made so far. We’re looking forward to making even more of an impact together.