Every Thursday, Terrie Loflin would leave her radiology job at the hospital to become a patient at the chemotherapy center across the street.
The routine lasted several months as Loflin battled breast cancer, all while juggling her husband’s recovery from a broken neck, the death of her mother and her daughter’s broken back from a serious car wreck.
“You find there’s a strength in you that you don’t think you had,” Loflin said of the journey. “You realize there’s a fight in you.”
Loflin, who continued working at
Novant Health Thomasville Medical Center throughout her cancer treatment in 2018, has approached each challenge with a fiery determination and an unmatched grit born out of a childhood tragedy.
She was 12 when her older brother, Mark, was diagnosed with a terminal brain tumor and, after a grueling five-year battle, he died at age 24 during her senior year of high school.
The strength Mark exuded as he graduated from community college despite his illness inspired Loflin’s nearly 30-year career in the medical field and motivated her in her own fight with cancer, she said.
“He was a strong person. He always stayed positive, always wanted to do the right thing,” said Loflin, a Winston-Salem resident. “He taught me to smile even through the hard times.”
Loflin has spent her career in radiology, helping patients, but she never expected she would be on the other side.
After the hospital got a new 3D mammography machine in October, 2017, Loflin — who was due for her annual mammogram appointment — became the first patient to use it.
The scan found abnormalities and Loflin, who had felt a lump before the screening, was advised to get a follow-up ultrasound and subsequently a biopsy.
“I was surprised,” said Loflin, the radiology manager at Novant Health Thomasville Medical Center. “I’m an optimist, so I think, during that time frame, I was concerned, but I also believed it would be a positive outcome.”
Loflin had to postpone her biopsy appointment for two months, after her mother got sick and she had to go to Ohio to take care of her.
After her mother’s death in mid-December, Loflin returned to North Carolina to get a biopsy and was diagnosed with breast cancer at the start of 2018.
“It was tough, you do put yourself on the backburner when you’re trying to help someone else,” said Loflin, who worked for 10 years at Moses H. Cone Memorial Hospital in Greensboro before coming to Thomasville. “I was very shocked. I felt like I didn’t know what to do, even after all my work in health care.”
After meeting with Novant Health specialists, who assuaged her fears, Loflin developed a treatment plan and was scheduled for a partial mastectomy in February 2018.
But a week before her surgery, her husband and college sweetheart, Mike, slipped on ice, hit his head and broke his neck.
He was able to have surgery a couple days later and has since recovered, but Loflin said the incident plunged her into uncertainty and fear.
“It was the breaking point,” said Loflin, a mother of two daughters. “I can’t even explain how much my family dropped everything. My girls are so strong. I felt very blessed.”
While both surgeries were successful, it wouldn’t be the last hurdle Loflin and her family would face.
A couple days after Loflin had her first chemo treatment, her daughter, Brittany, 21, broke her back in a car wreck when her vehicle flipped on the way home from church.
Later that week, Loflin ended up at the hospital, too, for five days in March with a high fever from the chemo and the stress.
After they both returned home from the hospital, her daughter began 18 weeks of physical therapy, which coincided with Loflin’s weekly chemo treatments.
The chemo was grueling and left her sick, especially every third week when they changed it up, she said.
“It would always knock me down pretty low. I lost about 20 pounds. It was pretty tough stuff,” she said. “Probably the hardest thing I’ve ever been through in my life.”
Her husband was still recovering from his injury six weeks earlier, but their family and friends provided invaluable support, she said, buoying them through the tough times.
While she said she thought about giving up many times, she drew strength from her faith and her brother, Mark, thinking of him especially as she completed chemo and embarked on 20 consecutive days of radiation treatment.
“I always think of him. We were very close,” she said. “(Radiation) was very much a trigger for remembering him, in a good way.”
Loflin said her brother’s radiation therapist used to bake him brownies, and his physical therapist consistently went out of the way to make him feel better.
Watching it all from the sidelines made her confident she wanted to be just like them and dedicate her life to helping people, she said.
Two months after his death, Loflin enrolled in a radiology program at Morehead State University in Kentucky.
Her own cancer journey has imbued her with an even deeper sense of compassion for her patients.
“It makes you see them from a different angle,” said Loflin, who has one grandson. “I know what they’re going through.”
Loflin continued to work throughout her treatment, taking only two weeks off for her surgery and one week off for her hospital stay.
She completed her last radiation treatment on her 48th birthday, Aug. 9, 2018, and is now cancer-free.
Loflin emphasized the importance of annual mammograms and early detection, which increases the chances that treatment will work.
She also credited Novant’s nurse-navigator program with helping her understand her initial diagnosis, set up appointments and providing her with the resources she needed.
Despite all the hardships interwoven into her cancer journey, Loflin said she has learned to never give up and live life to the fullest.
“You can get through anything,” she said. “You’re stronger than you think.”
A major residential and commercial development that was planned for land beside the BB&T Ballpark is no longer on the drawing board, although the landowners say 241 new luxury apartments could be ready for occupancy sometime in 2021 on Broad Street a little farther away.
Brand Properties, based in Atlanta, announced in 2015 that it was poised to build a million square feet of space for office, retail and residential use on the land where baseball fans now park beside the stadium. A city-financed parking deck was thrown in for good measure.
The project was called Brookstown District at BB&T Ballpark and was to occupy on land owned by Brookstown Development Partners LLC, a company managed by baseball stadium developer Billy Prim.
Bart Edge of Brookstown Development said this past week that Brand decided sometime in early 2018 that it would not go forward with the project, which was downsized before it came to Winston-Salem City Council later in 2015 for assistance on the parking deck.
“I have a lot of respect for Brand and appreciate all the time and money and effort he spent to consider the development,” Edge said, referring to Brand chief executive Brand Morgan. “Of all the things he had opportunities to pursue, this didn’t make it to the top of the list.”
Edge declined to say who is behind the new apartment project planned for Broad Street but said that Brookstown Development has signed an agreement with the developer to build 241 apartments plus a five-story parking garage that would not require city assistance.
“They are luxury apartments, and the developer has built in this area before,” Edge said, adding that more information about the project will come once the developer gets further along and commits to proceeding with the apartments.
The signed agreement doesn’t preclude the developer from pulling out of the project, but it does show it is a serious proposal, Edge said.
“It is not just kicking tires,” Edge said. “I can tell you that developers do their due diligence and are convinced there will be demand” for apartments.
On Broad Street, the apartments would be near a Bee Safe Storage and Wine Cellar being built on the southwest corner of First and Broad streets.
The new apartments would also join others that have gone up on the west side of downtown Winston-Salem in recent years.
West End Station recently opened nearly 230 apartments just up the road on Brookstown Avenue, joining another 200 units that Link Apartments Brookstown built across from the ballpark on Peters Creek Parkway in 2014.
The first pitch was tossed at BB&T Ballpark in 2010, but the stadium seating 10,000 was always considered to be the first part of a two-phase deal.
When Brand first announced in May of 2015, the plan consisted of almost 600 apartments, 300,000 square feet of retail space, an equal amount of office space, 250 hotel rooms and a pair of parking decks with a combined 1,000 spaces, financed by Winston-Salem.
It represented an investment that was close to $100 million.
When the plan came to the city that fall, it was trimmed back to around half the original size, with expectations for follow-up phase later on.
The city approved a deal to pay for a smaller parking deck at a cost of around $8 million.
The new plan for the apartments on Broad Street would not be financed with any taxpayer money, Edge said, and the parking deck for that complex would be financed entirely by the developer.
The apartment project would stretch from Broad Street to Second Street and require the closure of portions of Brookstown Avenue and Green Street where they pass through the block north of First Street.
Mayor Allen Joines said his understanding is that Brand “had difficulty making the final numbers work” when it looked at the earlier development closer in to the ballpark.
“There were some site-development issues,” Joines said. “The financing was a little tough, given the Business 40 work. There was some concern about a major road being closed, the uncertainty. A major retaining wall was needed from Broad Street all the way down to the first parking level. The cost of those (factors) kind of pushed the project out of feasibility for the type of development they were trying to do there.”
The development would confirm a continued demand for apartment living in downtown Winston-Salem, Joines said, adding that a recent study showed the city needed another 16,000 dwelling units all over town in the next eight years.
“Frankly, I think folks are waiting to see how it works out there when Business 40 gets done,” Joines said.
Edge said that with Business 40 deep in construction — the revamped freeway could reopen in early 2020 — construction woes will be a memory by the time the apartments open.
Brookstown Development still hopes to see development on the site that Brand turned down but added that it depends on what developers see “as the highest and best use of the property.”
“We still believe mixed use is the best development there and would like to see office and retail,” Edge said.
More than 720,000 state employees and their dependents and non-Medicare retirees and their dependents may learn in less than a week whether they will be considered as out-of-network with their health-care provider and local hospital starting Jan. 1.
A financial reimbursement game of chicken involving State Treasurer Dale Folwell’s attempt to move the State Health Plan to a government pricing model tied to Medicare rates could come to a head July 1.
The SHP is the largest buyer of medical and pharmaceutical services in North Carolina, spending $3.2 billion in 2017.
Folwell’s Clear Pricing Project would move the SHP away from a commercial-based payment model. He has set a deadline of June 30 for providers to sign a contract agreeing to the changes.
Folwell’s proposal would allow the SHP to begin paying about 61,000 providers based on a percentage above current Medicare rates, along with an additional and adjustable profit margin estimated at 82%.
The SHP plans to phase the rate changes in over a two-year period. First-year rates are projected to produce $196 million in savings, and another $62 million in year two.
Folwell stressed Thursday the June 30 deadline is firm with no planned extensions.
According to a WRAL report last week, the SHP currently has about 15,000 contracts in place.
The new plan has at least 640 signed contracts, representing at least 15,000 providers, but no hospitals or health-care systems. The contract has been available since May 13.
Folwell said May 13 that “we’ve had hundreds of requests for information and a lot of buzz around the new network. We’re confident that the state’s medical community will work with us to create this new network.”
“The backlog of those attempting to sign is growing by the hour,” Folwell said Thursday. “With the backlog, if it’s (submitted) on the line by the deadline, we will process it.”
“While encouraged by those who have signed, we empathize with those hospitals who feel threatened to stand idle when given the opportunity to provide health-care to teachers, troopers and other state employees at a Medicare rate, plus 82%.”
On June 24, Folwell said EmergeOrtho and OrthoCarolina have signed the contracts.
EmergeOrtho is one of the largest physician-owned orthopedic practices in North Carolina with more than 140 physicians, 130 advanced practice practitioners and 165 physical and occupational therapists. It has 50 office locations throughout 21 counties, as well as provides orthopedic urgent care services across state.
OrthoCarolina is one of the nation’s leading independent academic orthopedics practices with more than 300 providers. The practice has 31 office locations.
Other notable participants to date include: MinuteClinic facilities in CVS Pharmacy and Target stores; Rehabilitation Associates Networks; and the Community Care Physician Network, which represents 2,500 primary care clinicians.
The most recent comments from Novant Health Inc. and Cone Health indicate they still are reviewing the contract’s requirements. Wake Forest Baptist Medical Center has not responded when asked about its stance.
Novant said in a statement that “it is our understanding that State Health Plan members will have an opportunity to verify provider’s network status after July 1, and before their open enrollment (for 2020) begins on Sept. 29.”
The N.C. Healthcare Association said in a statement that “we cannot advise our members on contractual matters or speak for them when it comes to the new contracts. As far as we know, none of the hospitals in the state have agreed to participate.”
“From our perspective, NCHA is deeply concerned that the Clear Pricing Project is not what the name suggests.”
“Instead, the planned changes could catastrophically alter health-care delivery in North Carolina and put state employees, retirees and their families’ in-network access to high quality health-care and financial well-being at risk.”
Folwell, the SHP and the NCHA have been butting heads since Folwell unveiled his initiative in October.
Each claims the other side has not been willing to engage in earnest negotiations.
Dr. Michael Waldrum, the NCHA’s chairman and chief executive of Vidant Health in Greenville, has questioned the wisdom and timing of Folwell’s proposal, including to legislators.
He said the state health care system is bracing for the full impact of the latest phase of Medicaid waiver transformation between now and February.
However, the transformation could be affected by funding necessary for the rollout being unavailable as part of a potential delayed state budget after July 1.
“There’s a better way to do to this, and we stand ready to help the State Health Plan with providing better quality care at lower cost,” Waldrum said.
Folwell said the NCHA “has neither stood up, showed up or spoke up about how to increase transparency and lower health-care costs.”
Folwell said the SHP will provide increased reimbursement payments to most independent primary care physicians, behavioral health specialists and many rural hospitals.
The NCHA said June 7 it would make contract rates between providers and insurance companies available to the SHP and Folwell if it would help resolve the dispute.
NCHA president Steve Lawler expressed his willingness to meet with the SHP board of trustees and health-care providers “to collaborate on a plan to redesign care so that the state employees, teachers and retirees, who have spent their careers in service to our state, can proactively manage their own care in the most cost effective and transparent way.”
“If contract rates between providers and insurance companies are a barrier, then NCHA and our members would not object to those rates being disclosed to the treasurer and his staff.”
However, Folwell said June 8 that Lawler’s offer rings hollow to him and is just public posturing.
Folwell has expressed his frustration repeatedly, including during legislative committee meetings, about his inability to gain access to those contract rates from providers and insurers.
For example, Folwell said in September that in response to a public-records request to the UNC Health System that entire chunks of the response, pages in a stack a ½-inch thick, were redacted over and though critical information.
“They’re calling it ‘proprietary information,’ ’’ Folwell said.
UNC Health spokesman Phil Bridges told the Winston-Salem Journal in September that all agreements between hospitals, doctors and insurance companies are proprietary business agreements, are not subject to public release, but are independently audited.
The treasurer has the authority to decide on reimbursement cuts, but legislation could take that away from Folwell.
House Bill 184, which would halt Folwell’s initiative for at least a year in favor of a legislative study report, cleared the state House by a 75-36 vote April 3.
It has yet to be acted upon in the Senate since being sent to the Rules and Operations committee April 4.
Lawler acknowledged in his statement that “the Senate continues to side with the union (SHP) and not act on the bill.”
The NCHA said “individuals and families deserve to have in-network access to local hospitals and doctors that they know and trust”
“That is why we support passing HB184 as a path to study other options toward a better solution.”
Senate leader Phil Berger, R-Rockingham, said Wednesday that he doubts a legislatively mandated delay would help.
“I suspect ... that we’d be in the same position when we get to that (delayed) date,” Berger said.
The legislature was in charge of SHP oversight before the Republican super-majority earlier this decade placed oversight into the treasurer’s office.
Berger told WRAL he’s not interested in second-guessing the way Folwell, a fellow Republican, runs the plan.
“If we get into micromanaging how the treasurer is making decisions, then we may as well just take the State Health Plan back,” he said.