The North Carolina Healthcare Association represents the collective voice of more than 130 hospitals and health systems across our state. In today’s rapidly evolving healthcare environment, hospitals are responding to numerous challenges that impact our ability to meet our mission to provide quality healthcare to everyone in the communities we serve. We are ready to partner with lawmakers to ensure North Carolina’s hospitals and health systems have the financial stability and resources needed to serve the everyday healthcare needs of their communities.
The following is a list of state legislative priorities, and the associated position statements, that were approved by the Board of Directors for use during the 2025 Legislative Session:
NCHA supports policies that improve access to high-quality healthcare by addressing the root causes of inequality for behavioral health patients.
The Certificate of Need law ensures that healthcare services are right-sized for their communities, guaranteeing access for all patients. NCHA supports the current Certificate of Need program and opposes any changes that undermine patients’ access to care.
Patients can count on North Carolina hospitals to provide 24/7 specialty, critical, and emergency care. Our hospitals are on standby to treat anyone who walks through their doors, at any time. Facility fees finance this level of care that only hospitals provide. NCHA strongly supports facility fees, better described as care-team fees, as they are fundamental to patient care and serving the healthcare needs of the community.
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Every North Carolinian deserves access to highly trained doctors. North Carolina should continue funding medical education programs and explore ways to draw down more of our Federal tax dollars to add more slots to train medical students.
NCHA urges policymakers to continue supporting CMS’s Medicaid Directed Payment Program (DPP) to ensure the state’s vulnerable population receives needed care without new General Fund requirements. This program improves beneficiaries’ access to care, enhances quality care and aids safety-net hospitals. NCHA urges timely annual submission of the preprint without conditions and maximizing available federal funds through the HASP program.
NCHA supports comprehensive solutions addressing the entire workforce pipeline, from preparing tomorrow’s healthcare leaders through world-class education programs to bolstering the resiliency of today’s healthcare workforce so they can continue to provide high-quality patient care. Hospitals, through their clinical leadership, should continue to have autonomy to make staffing decisions to ensure compassionate and quality delivery of healthcare across our state.
Hospital at Home is a promising model for health care organizations to deliver hospital-level treatment in a patient’s home. NCHA supports efforts to make Hospital at Home more accessible and to guarantee all providers offering the program can be sufficiently reimbursed by all payors.
When hospital teammates and patients enter a North Carolina hospital, they deserve a safe environment. NCHA supports policies that empower hospitals to create individualized workplace safety protocols that promote safety and wellbeing for patients and team members and eliminates violence in all forms.
Healthcare coverage with high out-of-pocket expenses, such as high deductible plans, stick patients with large bills when they need medical care. NCHA supports policies that bring transparency to insurance plans’ benefit design and coverage while reducing practices that cause delays in delivering timely care to our patients. Certain insurance practices, like inappropriate prior authorization and murky medical review standards, only serve the insurers’ bottom line. By reforming these practices, patients will receive necessary care how and when it is needed.
Medical debt is a complex issue that involves the full healthcare ecosystem. NCHA strongly supports solutions that holistically address the root causes of medical debt involving all the responsible stakeholders. Solutions include addressing insurance benefit design and curtailing insurance practices that delay and deny care, employer education on types of insurance plans and their benefit design, and hospitals’ providing generous charity care policies and practices as currently outlined in federal law.
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Medicaid is an important program which ensures that the state’s vulnerable population receives needed care. NCHA supports a managed care program that provides patients access to high quality care, reduces provider and patient administrative burden, and leverages all available federal funds.
Our patients deserve to have peace of mind about their healthcare finances, and NCHA supports efforts to protect patients from surprise bills. Federal law should encourage private negotiations between providers and insurers without government controls while ensuring providers are not financially harmed by disproportionately larger payors controlling reimbursement rates. NCHA supports collaboration with policymakers to ensure that Price Transparency and Surprise Billing Regulations benefit patients and maintain patient access to affordable healthcare.
North Carolina should join the majority of states that require insurance companies to honor the wishes of our patients by allowing providers to receive payments directly from insurers thereby eliminating the potential of putting patients in the middle.
North Carolina’s not-for-profit hospitals and health systems support the current non-profit sales and property tax laws and support efforts to exempt non-profits from paying sales taxes.
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The role of telehealth cannot be overstated in bringing care to communities who would otherwise not have access; telehealth has proven a critical component of healthcare. To bring healthcare to every North Carolina community, NCHA supports:
Hospitals and health systems provide patients with the information they need such as out-of-pocket costs, quality metrics, and associated health outcomes to make informed decisions about their health and healthcare as required by federal law and regulations. NCHA supports policies that bring cost transparency to patients’ and their out-of-pocket costs that include reforms to well-documented and widespread insurance practices that delay and deny patients’ care and health insurance coverage.
White and brown bagging policies benefit insurance companies and have led to dangerous scenarios for patients and the clinicians who take care of them. NCHA supports prohibiting the use of both exclusive white and brown-bagging policies that compromise the timing and/or quality of care of drug therapies delivered to patients.
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