Tufts Health Plan and Harvard Pilgrim Health Care Sign Definitive Agreement to Combine Organizations

Creates preeminent, nonprofit regional health services organization focused on improving affordability, increasing access to high-quality health care, and enhancing member experience

Wellesley, MA, and Watertown, MA – Harvard Pilgrim Health Care and Tufts Health Plan announced today their intent to combine their nonprofit organizations. The new organization, yet to be named, will become one of the region’s largest nonprofit health services organizations, providing health coverage in all segments of the market regardless of a person’s age, income, life circumstance, or health status.

Both organizations share the same vision that a combined organization will be even more effective, better able to keep high-quality health care accessible and affordable, while at the same time investing in programs and initiatives that enhance quality.

The board of directors will comprise equal representation from both organizations and will be chaired by Joyce Murphy, who currently serves as chair of the board for Harvard Pilgrim Health Care.

Tom Croswell, president and CEO of Tufts Health Plan, will serve as CEO of the new organization. Michael Carson, who serves as president and CEO of Harvard Pilgrim Health Care, will serve as president and oversee the organization’s diverse business lines and subsidiaries.

“Through the combination of two strong organizations with a commitment to non-profit health care in New England, we will be able to provide even greater value to consumers, as well as improve access to care throughout the region,” said Joyce Murphy, chair of the board for Harvard Pilgrim Health Care.

“Building upon our collective synergies and strengths – which includes being among the top-rated health plans in the country for quality – will unlock value that can be immediately reinvested in our members and the communities we have the privilege of serving,” said Greg Tranter, chair of the board for Tufts Health Plan. “I am excited about the future.”

“Our communities and consumers today face four major hurdles in health care:  affordability, access, quality of health, and a fragmented health care experience across various stakeholders and health systems. Through our shared vision, we believe we can tackle these issues and bring more value to the communities we serve,” said Tom Croswell, president and CEO of Tufts Health Plan.

The new organization will harness the combined strengths of the respective organizations and bring value to the community by:

• Improving affordability through scale and administrative cost efficiencies, providing high value, more affordable health plans to consumers
• Increasing access through geographic reach and product diversity by enhancing population health capabilities, enabling care for underserved communities, and offering a broader set of insurance choices across age and income groups
• Improving quality of health through enhanced capabilities for population health and clinical engagement.  The new organization will build upon a rich legacy of provider collaborations, promoting investments in population health capabilities
• Streamlining customer experience through investment in innovative tools and capabilities

The new organization will serve close to 2.4 million members in Massachusetts, Maine, Connecticut, New Hampshire and Rhode Island, offering employer-sponsored plans; Medicare and Medicaid plans; Qualified Health Plans; and plans for those who are dually eligible for Medicare and Medicaid.

Philanthropy, community engagement and corporate citizenship will remain a priority for the new organization – both Tufts Health Plan and Harvard Pilgrim Health Care have a rich history of supporting the communities they serve and are committed to building upon that strength. In 2018 alone, both organizations’ combined giving totaled more than $9 million.

The agreement, which was unanimously approved by both boards, is subject to multiple local and federal regulatory approvals during which time the organizations remain independent companies.

About Tufts Health Plan

Tufts Health Plan is nationally recognized for its commitment to providing innovative, high-quality health care coverage.  Staying true to our mission of improving the health and wellness of the diverse communities we serve, we touch the lives of more than 1.16 million members in Massachusetts, Rhode Island, Connecticut, and New Hampshire through employer-sponsored plans, Medicare, Medicaid, and Marketplace plans, offering health insurance coverage across the life span regardless of age or circumstance. In addition, our subsidiary, Integra Health, a specialty benefits organization, contracts with health plans to serve the Durable Medical Equipment and Prosthetic and Orthotic supply needs of 15 million patients nationwide.

We are continually among the top health plans in the country based on quality and member satisfaction. Our Tufts Medicare Preferred HMO and Senior Care Options plans received a 5-star rating from the Centers for Medicare & Medicaid Services, the highest rating possible.¹

About Harvard Pilgrim

Harvard Pilgrim Health Care and its family of companies provide health benefit plans, programs, and services to more than 3 million members and customers, including its subsidiaries that serve national self-insured and population health customers, in New England and beyond. A leading not-for-profit health services company, we guide our members — and the communities we serve — to better health. Founded by doctors 50 years ago, we’re building on our legacy. In partnership with our expansive network of doctors and hospitals, we’re improving health outcomes and lowering costs through clinical quality and innovative care management. Our commitment to the communities we serve is driven by the passion of the Harvard Pilgrim Health Care Foundation. Through its work, low- and moderate-income families are gaining greater access to fresh, affordable food — a cornerstone to better health and well-being. Learn more at www.harvardpilgrim.org. Connect with us on Facebook, Twitter, YouTube and LinkedIn.

1. Every year, Medicare evaluates plans based on a 5-Star rating system. Star Ratings are calculated each year and may change from one year to the next. For more information on plan ratings, go to www.medicare.gov. Tufts Medicare Preferred HMO plans received 5 out of 5 stars for contract years 2016, 2017, 2018, 2019.