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. The company was founded in 1979.
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 35,000 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.
Tufts reported a 12% increase in revenues to some $2.9 billion in 2011 due to increased membership levels. The company also attributes its financial success to ongoing efficiency and cost-control efforts, as well as its increased offering of high-demand, affordable products. It reported net income of nearly $88 million in 2011, a 49% increase over the prior year from increased operating income levels.
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. 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.
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.
Mergers and Acquisitions
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.