Getting good health care becomes a little less rough with Tufts. Tufts Associated Health Plans is a leading New England health insurer operating as Tufts Health Plan. The company provides medical coverage to about 1 million members in Massachusetts and (to a lesser degree) Rhode Island. Its products include HMO, PPO, and point-of-service plans for both employers and individuals, as well as Medicare Advantage plans for retirees and managed Medicaid plans for low-income families. With partner CIGNA, Tufts also offers a nationwide health network called CareLink for multi-state employers.
Tufts and its subsidiaries have offices in Boston, Medford, Springfield, Watertown, and Worcester, Massachusetts. It also has an office in Providence, Rhode Island.
Tufts' health care network includes about 90 hospitals and 25,000 doctors. In addition to basic health plans, the company's offerings also include consumer-directed products such as health savings accounts and health care reimbursement accounts.
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The company serves the commercial, Medicare and Medicaid/subsidized health insurance markets.
Tufts revenue was $3.9 billion in 2013. It reported a 32% drop in net income that year, due to decline in operating income partially offset by a growth in investment income.
Like most managed health care companies, Tufts has worked to control medical costs while still adding members and encouraging quality care. For instance Tufts has implemented disease management programs, which help members manage chronic illnesses, and it has introduced a set of online wellness tools that offer services including patient education, prescription reminders, and claims resolution. On the provider side, Tufts works to build its network of participating medical professionals by providing services designed to streamline their practices and reduce administrative costs. It encourages providers to use technology to standardize best practices and to promote the use of personalized health records.
With a focus to integrate behavioral health and the patient-centered medical home model for primary care in Rhode Island, Tufts announced plans in 2015 to fund three projects in that state to test strategies for increasing patient access to behavioral health services within primary care settings.
In 2014 Tufts launched EmpowerMe, an online cost estimator tool that allows members to more effectively manage their health care costs by providing highly personalized cost information on their medical treatments and out-of-pocket expenses.
That year, Tufts, Saint Vincent Hospital, and MetroWest Medical Center signed a new multi-year contract that will keep Saint Vincent Hospital in Worcester and MetroWest Medical Center in Framingham and Natick (all in Massachusetts) “in-network” for Tufts members.
In 2013 the company launched the Tufts Health Plan Senior Care Options (SCO) program in Barnstable County, Massachusetts.
The company has also introduced new low-cost plans, including the Your Choice tiered-network option and the Steward Community Choice limited network option (a partnership with Steward Health), both launched in 2011.
Tufts entrenched itself even deeper into the Massachusetts health care market by acquiring health plan provider Network Health from the Cambridge Health Alliance in late 2011. The purchase of Network Health brought about 180,000 members to the Tufts network and expanded Tufts operations into the Medicaid managed care market. Network Health, which became a subsidiary of Tufts, offers two Medicaid options under state programs (MassHealth and Commonwealth Care) for low-income residents.
The company was first established in 1979.