Partners HealthCare to Self-Insure 100K Employees

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AutoInsuranceMM.Info – Low income insurance – Partners HealthCare to Self-Insure 100K Employees

By Thomas Beaton

– Partners HealthCare has announced it will self-insure 100,000 of its employees, transitioning coverage from BlueCross BlueShield of Massachusetts to its own Neighborhood Health Plan, according to The Boston Globe.

“Neighborhood Health Plan looks forward to helping Partners offer the affordable, high-quality health care coverage that Partners employees have come to expect,” David Segal, President and CEO of Neighborhood Health Plan, told HealthPayerIntelligence in an emailed statement.

“We are confident that Neighborhood’s proven capabilities, including our best-in-class customer service, will create a positive experience for Partners employees as they have for our growing commercial membership.”

Rosemary R. Sheehan, Partners HealthCare chief of human resources, told the Globe that the change is an effort to control health plan costs and reduce out-of-pocket spending for employees.

Currently, Partners HealthCare spends roughly $830 million annually on employee health benefits. Sheehan added that Partners expects to save between $10 to $15 million a year by transitioning employees to Neighborhood Health Plan coverage.

Partners informed employees that their benefits would not change under the move to Neighborhood Health Plan. Partners will also invest in additional care coordination efforts, while offering enhanced wellness benefits, smoking cessation programs, and related programs for employees.

“Any change to health benefits at all creates anxiety,” Sheehan told The Boston Globe. “The way we’re handling that is by really providing a lot of resources,” including an informational website for employees and town hall meetings.

In addition, Partners and Neighborhood Health Plan will invest in new programs that address complex health conditions for underserved populations and develop family-centered models of care.

The move now nearly doubles Neighborhood Health Plan’s commercial membership. Before the transition, Neighborhood Health Plan covered roughly 32,000 Medicaid beneficiaries and 100,000 commercial members.

The commercial membership of BCBS of Massachusetts will drop from 2.8 to 2.7 million beneficiaries as Partners begins to transition employees to the new health plan. The payer expected the change, but was ultimately disappointed by the change, and will continue to focus on their current membership’s needs.

“Partners has been a valued BCBSMA customer for more than 20 years,” Amy McHugh, a spokesperson at BlueCross BlueShield of Massachusetts told HealthPayerIntelligence in an email.

“We’re disappointed with this decision to insource their employees’ coverage, but not surprised. Partners let us know a year ago that this was a possibility and we understand that they are in the process of trying to reposition NHP [Neighborhood Health Plan] from a Medicaid plan to a commercial plan,” McHugh added. “We will support the transition to NHP on January 1, 2019, and in the meantime, we remain focused on acting in the best interest of our employer customers and nearly 3 million members, making quality care accessible and affordable.”

Partners HealthCare’s decision to cover employees with a self-insured health plan comes after recent discussions with Harvard Pilgrim to engage in a potential merger. Early discussions of the merger indicate that both organizations believe consolidation would create lower costs and better outcomes for 1.2 million beneficiaries.

The merger would combine Partners HealthCare, Massachusetts’ largest provider, with the state’s largest payer organization.