Care N.E. picks Tufts over Blue Cross
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COURTESY TUFTS HEALTH PLAN
“WE ARE EXCITED at this opportunity and remain confident that with our attention on prevention and wellness, Care New England employees will have a good experience as Tufts Health Plan members,” said James Roosevelt Jr., Tufts’ president and CEO.
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PROVIDENCE – Amid a contract dispute that threatens to push Care New England out of the Blue Cross & Blue Shield of Rhode Island (BCBSRI) provider network on Jan. 1 (READ MORE), the local health system has chosen to end its relationship with Blue Cross as its workers’ health insurer, also effective Jan. 1.
Instead, Care New England announced today, Tufts Health Plan will cover its employees and dependents, more than 9,000 people total, or about 1.3 percent of Blue Cross’ book of business.
The choice was made after an “active bid and review process,” the company said.
“Our selection of Tufts Health Plan was based on its outstanding reputation for member and physician service and their very competitive rate,” said John J. Hynes, president and CEO of Care New England, in a news release. “We are pleased to be one of the first major employers to sign on with the health plan and welcome them back to Rhode Island. We believe Tufts Health Plan offers high-quality, affordable insurance products that deliver access to the best hospitals, physicians and specialists in the state.”
Just last week, Tufts was rated No. 2 in the nation among commercial insurers in U.S. News & World Report’s “America’s Best Health Plans,” which is produced in collaboration with the National Committee for Quality Assurance. Harvard Pilgrim Health Care was ranked No. 1.
Tufts President and CEO James Roosevelt Jr. said in a statement that adding Care New England to the insurer’s roster of clients is “especially gratifying.” With its re-entry into the Rhode Island market on Jan. 1 (READ MORE), Tufts will become the state’s third commercial health insurer, joining market leader BCBSRI and rival UnitedHealthcare of New England.
“We appreciate the trust that Care New England has placed in our organization to provide outstanding coverage to its employees,” Roosevelt said. “We are excited at this opportunity and remain confident that with our attention on prevention and wellness, Care New England employees will have a good experience as Tufts Health Plan members.”
Asked for comment, Christopher J. Medici, chief communications officer for BCBSRI, said the company “is disappointed whenever we lose a customer, no matter how big or how small.”
“We believe we priced the Care New England contract fairly, given the depth and breadth of our coverage and the quality of service we provide,” Medici added. “That being said, we’re committed to ensuring a smooth transition for Care New England, its employees and their families.”
According to Care New England, an analysis of Tufts’ network has showed that at this time, there is better than a 90-percent match for physicians, hospitals and specialists currently used by its health plan members and the ones they will be able to use with Tufts.
In addition, more providers are expected to join Tufts as a result of the Care New England deal, both companies said. For the “small number” of providers who are not in the Tufts network, Care New England said that as a self-insured employer, it will “bridge the gap,” continuing to cover claims as if those providers were in the network through March 31, to give them time to negotiate with Tufts.
Care New England – founded in 1996 – is a nonprofit health-care network taht includes Butler Hospital, Kent Hospital and Women & Infants Hospital; as well as a visiting nurse and home care/hospice agency, Care New England Home Health; and the Care New England Wellness Center. For more information, go to www.CareNewEngland.org.
Tufts Health Plan, based in Watertown, Mass., is a nonprofit health-maintenance organization (HMO) with about 680,000 members. For more information, go to www.tufts-healthplan.com.
Blue Cross & Blue Shield of Rhode Island, based in Providence, covers more than 670,000 members. BCBSRI is an independent licensee of the Blue Cross and Blue Shield Association. Additional information is available at www.bcbsri.com.