Why Choose a Local, Nonprofit Health Plan?

Tufts Health Plan is—and always has been—a nonprofit company. We’re also a local company, serving members in the same places where our employees live and work.

business people meeting for coffee

Those two facts are essential to who we are and how we serve our members. As a nonprofit, Tufts Health Plan doesn’t have a fiduciary responsibility to shareholders to maximize profits. This means that we can focus on providing the best solutions for our members, even if they’re not necessarily the most profitable ones. For example:

  • Education, not surprise charges. To trim waste and maximize profits, some health plans try to steer their members away from costly trips to the emergency room by surprising them later with a bill for the full price of the visit if their condition was coded as non-life-threatening. We take a different approach: we educate our members about the difference between urgent and emergency care and offer alternatives to the ER, like telemedicine, for non-life-threatening conditions.
  • More prescription drug choices. Some health plans force their members to switch to lower cost or generic versions of their prescription drugs if they’re available. At Tufts Health Plan, we educate our members about lower price drug options instead. Looking at anonymized population health data, we can glean insights about which drugs or combinations of drugs are most effective in treating and managing various conditions and provide that information to our members so they can make their own choices.
  • Flexible plan design. We don’t have to answer to shareholders about the structure of our plans. This means we have the freedom to design plans that will work best for employers, based on their specific needs and employee populations.

As a nonprofit, we don’t have a fiduciary responsibility to shareholders to maximize profits.

 

We Continuously Invest in Ways to Serve Our Members Better

Not having to pay dividends to shareholders means we can invest resources back into our company, with the goal of offering ever-better, more affordable care to the diverse communities we serve. That includes investing in technology and systems that enable us to administer our plans in the most efficient and cost-effective ways; enhancing communication with our providers, so we can be more collaborative; and having more doctors and nurses on our staff to support care management and to provide expertise as we design plans and benefits.

We Understand Where You’re Coming From, Because We’re From Here Too.

As a local, New England plan, our employees live, work, play and shop in the same places our members do. We see the same doctors, and even have the same health plan—ours. 75,000 health care providers in Massachusetts & Rhode Island are covered by Tufts Health Plan too.

As a local, nonprofit health plan, we can do more to make high quality health care accessible and affordable for the people of Massachusetts and Rhode Island.

 

Unlike a huge, out-of-state provider, we have our finger on the pulse of health care here in Massachusetts and Rhode Island. We meet face-to-face with our providers and walk the halls of the facilities where our members get care. Meanwhile, we can make genuine connections with our members, brokers and plan sponsors. We understand—and often share—the challenges they face, from the high cost of housing to the difficulty of digging out from a Nor’easter.