The state of North Carolina, like many other employers, is trying to get a handle on the rising cost of health care. The state is taking a step toward lowering costs for state workers by taking control of how much it pays for each visit to mental health and primary care providers. Since the cost of care varies widely across the state, the plan is to even out payments to doctors and hospitals. Therapists and independent primary care doctors stand to benefit, while large institutions are likely to see a cut. The state treasurer wants to push the savings down to state workers with families who now pay high monthly premiums for coverage.