Harvard Pilgrim Health Care takes care of New Englanders. A leading provider of health benefits in Massachusetts, the not-for-profit organization also offers plans to residents of New Hampshire and Maine. It has more than 1 million members enrolled in its HMO, PPO, point-of-service, and government plans. Those members have access to regional and national networks of hospitals and doctors. Harvard Pilgrim also targets multi-state employers with its Choice Plus and Options PPO plans, offered through a partnership with UnitedHealthcare. Harvard Pilgrim has a network of more than 135 hospitals and 28,000 doctors and clinicians.
The company operates in and around Maine, Massachusetts, and New Hampshire.
Additionally, the company collaborates with Harvard Medical School to perform research that is focused on health care systems (treatments and costs) and patient populations through the Department of Population Medicine within its Harvard Pilgrim Health Care Institute.
The Harvard Pilgrim Foundation provides community health and wellness programs.
Harvard Pilgrim's revenues dropped by 6.6% in 2011. However, the company's net income grew by 88% in 2011 due to a decrease in operating expenses thanks to a reduction in medical costs and interest expenses coupled with an increase in net investment income.
Harvard Pilgrim's plans are primarily offered to corporate groups. The company's primary goal is to maintain a loyal customer base while attracting new clients. In support of its ambitions, Pilgrim Health has expanded the breadth of its plan offerings and widened its network of contracted health providers to maintain its competitive edge.
It also enrolls Massachusetts residents in low-cost coverage plans as part of the state's mandate, passed in 2006, that requires every resident to have health insurance. The company also manages New Hampshire's Healthy Kids program, which covers low-income children.
In addition to its direct insurance offerings, the company provides third-party administrative services for self-insured plans through its Health Plans subsidiary. It has been growing this part of its business through acquisitions, including the purchases of regional third-party administrators.
In 2011 Harvard Pilgrim signed a lease to open a Central/Western Massachusetts regional office in Worcester to focus on expanding the insurer's presence in the counties of Worcester, Hampden, Hampshire, and Franklin.
That year the company explored options to merge with another top Massachusetts insurer, Tufts Associated Health Plans, with the goal of increasing operational efficiencies and controlling rising health care costs. The talks were short-lived, however, and called off when it was determined that such a merger would not be worth the effort.
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