Tufts Health Plan Improves Care Through Collaboration

Tufts Health Plan is expanding services for its members through strategic partnerships

Healthcare insurance can be quite confusing for consumers. Between HMOs, PPOs, and health savings accounts and premiums, copays, and deductibles, people can often feel overwhelmed by their choices. On top of that, individuals need to consider the quality of the services they’re getting for what they’re paying.

The team at Tufts Health Plan (THP) is aware of this delicate balance. That is why it has enacted several measures over the past few years to maximize patient care while minimizing costs for patients. One of the main strategies that the organization has used to combat rising healthcare costs while expanding services under its healthcare plans involves partnering with care providers throughout Massachusetts and Rhode Island.

Embarking on Strategic Partnerships

Since 2015, the company has embarked on a series of collaborative relationships that have broadened care services for Tufts members in areas such as primary, behavioral, and dental health, and expanded services to Medicare and Medicaid populations. One of the first major partnerships for Tufts of the past few years began in July 2015 with Iora Health.

For the past three years, Tufts has worked with Iora to bring high-quality care to its Medicare patients in the greater Boston area. Under the agreement, Iora provides primary medical care for Tufts members on the company’s Medicare Preferred HMO and Senior Care Options plans. The partnership has not only been beneficial for both parties, but more importantly, it’s benefited patients.

“Iora Health’s innovative care model and increased access to care align perfectly with THP’s integrated care management model, which has been shown to improve our members’ health and wellness,” THP president of senior products Patty Blake said in a news release.

Tufts’s alliance with Iora kicked off a series of other partnerships, chief among them relationships with the State of Rhode Island and Delta Dental of Massachusetts.

The Impact of Collaboration

In March 2017, Tufts began a partnership with Delta Dental of Massachusetts focused on better care coordination and disease prevention. “There are many studies which suggest that there is a link between oral health and chronic medical conditions,” Marc Spooner, THP president of commercial products, said in a news release. “This collaboration is unique in the marketplace and is another example of our commitment to finding innovative solutions to increase coordination with our providers while reducing costs for employers.” The joint venture will allow the two organizations to share information with each other and work to increase member engagement with their personal health plans. The relationship will benefit employers, as well. Companies with between 51 and 250 employees that purchase health plans that bundle THP and Delta Dental together are eligible for a premium discount.

Just a few months later, the company launched another important partnership. As of June 2017, THP has been collaborating with Rhode Island’s Executive Office of Health & Human Services to create a new program called RITogether. The new initiative will allow the state’s Medicaid beneficiaries to utilize primary and behavioral healthcare through Tufts’s network of providers.

“We are very holistic in our approach [to healthcare],” Helene Forte, Tufts’s vice president of care management, told HealthPayerIntelligence.com. “We focus not on just physical, but also mental and behavioral, as well as social determinants of care.”

Helping Patients Quickly and Effectively

State officials have been quite enthusiastic about the Tufts’ partnership. “We are ecstatic that Rhode Islanders receiving Medicaid will now have another great option for administering their healthcare benefits,” Patrick Tigue, Rhode Island’s Medicaid director, told HealthPayerIntelligence.com. “Tufts Health Plan has an outstanding reputation, and we are happy they [are partnering] with us and [expanding] in our state.”

The goal of the program is to strengthen the relationship between care providers and patients and improve responsiveness to changes in patient health. The partnership aims to allow physicians to detect changes in patients’ health more quickly, which will let them adjust patients’ treatment plans accordingly.

Based on the success of its current initiatives, it seems as though Tufts will continue to collaborate with its partners in healthcare to further its goal of improving patient care and minimizing costs to patients throughout Massachusetts and Rhode Island while looking for new relationships to forge.

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