More than a Buzzword
For 40 years, we’ve been working hand-in-hand with doctors and hospitals to make higher quality and more affordable care a reality for the businesses and individuals we serve.
We believe the key to lower health care costs is better health care.
It’s an investment that’s paid off. Tufts Health Plan is consistently named one of the top health plans in the country when it comes to quality. According to the National Committee for Quality Assurance (NCQA)'s Private Health Insurance Plan Ratings 2018–2019, our Commercial HMO/POS/EPO and PPO plans in Massachusetts and our HMO/POS plans in Rhode Island received 4.5 out of 5 ratings. No other health plan in Massachusetts or Rhode Island performed better. In addition, our Tufts Medicare Preferred plan is the only health plan in Massachusetts to receive the highest five-star CMS rating the last three years.
We strive to set the standard for outstanding quality health care, service, and value. And we're committed to providing innovative, high-quality health care coverage. The plan offers members and employers an array of health management programs, which support evidence-based approaches to health and wellness.
Our Provider Network
We recognize that improving health care quality is a team effort. That’s why our network includes some of the best doctors and leading hospitals in the world. Our providers are required to meet and maintain the highest-quality standards to become part of our network.
PCP Medical Record Reviews
Primary Care Provider medical record reviews are performed periodically on certain PCPs to assess compliance with standard medical record keeping and documentation practices.
The Leapfrog Group
We request that all Massachusetts hospitals report their compliance with Leapfrog Group
initiatives annually. The Leapfrog Group works to improve hospital systems that have the potential to harm patients.
All prescriptions filled by Tufts Health Plan members at any CVScaremark®-participating pharmacy are screened for safety and appropriateness - including drug-age conflict, drug-drug interaction, drug-pregnancy conflict, drug-disease conflict, and late refill.