Expanding and Evolving the Provider Network for Better Outcomes and Controlled Costs
A network that works better for everyone
A health plan is only as strong as its provider network. And ours couldn’t be stronger. Not just because of the number of hospitals and providers it includes in New Hampshire, Rhode Island, and Massachusetts. But also because of how we’re collaborating with providers and health care systems to make health care work better for our members.
1. Depth, breadth, and quality
Members want choice when it comes to their coverage. And in a region like New England, where living in one state and working or traveling to another is common, Tufts Health Freedom Plan believes members should have the freedom to get care where they want, from the providers they want.
Our service area covers New Hampshire, Massachusetts, and Rhode Island, with parts of Maine and Vermont, including the following:
- More than 51,000 providers, including ancillary, PCPs, and specialists
- More than 100 hospitals1, including Boston’s world-renowned teaching hospitals1
- For national coverage, we provide access to nearly 800,000 providers, more than 4,800 hospitals, and 90,000 ancillary facilities
- Worldwide emergency coverage
Celebrating the Strength of Regional Hospitals
Catholic Medical Center in Manchester, New Hampshire
The first commercial site in New England to implant the WATCHMAN Left Atrial Appendage Closure (LAAC) device in patients with non-valvular atrial fibrillation (AFib). More recently, it became the first hospital in the world to enroll patients in a clinical trial testing the WATCHMAN in patients who can’t tolerate blood thinners.
“Patients with AFib have a higher risk of stroke but treatment has been limited for those who couldn’t take blood thinners,” said cardiologist Connor Haugh, MD, who implanted the first device in the trial. “This is a truly exciting option for both patients and us as their caregivers.”
2. Collaborating with providers for better care
Doctors love working with us—and the feeling is mutual. Strong provider relationships and more collaborative models of care are at the heart of our core business strategy. By sharing data, innovations, and incentives, we can control costs while providing our members with quality care. Our strong relationships and unique collaborations with providers are quite literally changing the way health care is delivered—to the benefit of our members.
Employers' interest in new care delivery models, including high quality and joint venture plans, has doubled over the past 6 years2
In New Hampshire, we’re working with Granite Health, a collaboration of six of the state’s leading high-value health systems: Catholic Medical Center, Concord Hospital, Exeter Health Resources, LRGHealthcare, Southern New Hampshire Health, and Wentworth-Douglass Hospital. Through our arrangement with Granite Health we can:
- Share best practices and innovations. The care managers and medical leadership from Granite Health and Tufts Health Freedom Plan meet monthly to discuss clinical and product initiatives and develop integrated care solutions.
- Share data across institutions. Our teams can quickly communicate about care plans, to get a more complete view of patient care and reduce duplication of diagnostics.
- Reduce gaps and overlaps in care. Granite Health shares data with our nurse care managers, allowing us to offer proactive support for individuals who need it most and avoid duplication of services.
3. The power of tiered networks for cost savings
Through our relationship with Granite Health, members not only benefit from quality care. They can also save money. Members pay lower out-of-pocket costs when they choose providers in the Granite Health provider network, through our Granite Premier Choice tiered plan options. Preferred providers, meanwhile, are incentivized to keep quality high and costs low. These preferred providers span 10 of New Hampshire’s top hospitals as well as leading hospitals in Boston. Granite Premier Choice PPO and EPO tiered plans offer members incentives to select high-value providers through lower copays, deductibles, and coinsurance. Of course, members still have the option to see any doctor in our network and pay a higher share of the cost.
The CEOs of the five health systems that established Granite Health recognized that health care in New Hampshire and around the country was changing in a way that compelled all of us to work together. By doing so, our health systems have been able to achieve much more than they could on their own.
-Rachel Rowe, President and CEO, Granite Health