New Health Care Plan Coming To NH

For years, health care rates have been a constant tug of war between providers and insurers, with insurers looking to reimburse less and providers wanting to be paid more. A new health plan in NH looks to end that by bringing the two sides together under one roof. The Tufts Health Freedom Plan is an insurance company jointly owned by Tufts Health Plan and Granite Healthcare Network, which is comprised of five large health care systems in NH.

"It was important to fully align our incentive upon clinical excellence and administrative efficiencies. By creating a new insurance company we marry those,” says Rachel Rowe, executive director of Granite Healthcare Network, which she says uses the scale, scope of services and large patient pool to provide high quality and low cost care by sharing data, instituting a population health management system and pooling administrative capabilities.

Granite Healthcare Network is comprised of Catholic Medical Center based in Manchester, Concord Hospital in Concord, LRGHealthcare in Laconia, Southern NH Health System in Nashua and Wentworth-Douglass Health System in Dover. Together the five systems employ over 10,000 full-time equivalent employees and provides services to nearly 500,000 residents.

Tufts Health Freedom Plan applied for an insurance license from the NH Department of Insurance and plans to launch operations by Jan. 1, 2016, initially with the 15,000 employees and their spouses and dependents. But Rowe stresses this is a “statewide insurance company” and that plans will be offered to large and small employers, along with individual plans on the Health Care Marketplace. The hope is that all NH hospitals, as well as those in Northern Massachusetts, will join the plan.

Rowe says the Granite Health Network has already laid the groundwork for coordination by sharing patient data, resources and best practices among the five hospitals to provide the most effective and coordinated care. With the insurance company working side by side with the providers, she says patient data and claims data can both be considered when developing best practices for what services are best in what setting. That is rarely done now. How this patient data sharing would work for hospitals not now in Granite Health Network “will be tricky” as every hospital uses different data management systems.

Details on the budget for the new company, and the kinds of plans and their premium costs, are not yet finalized. After a license to sell insurance is approved, the plan then needs to file a plan for what plans will be offered and what will be included in them with the Insurance Department.

Brian Wells, former CEO of Memorial Hermann Health Solutions (MHHS), part of Memorial Hermann Health System of Houston, is president of the new company. The inaugural board of directors includes NH executives: Joseph B. Reilly, NH regional president of Eastern Bank; Michael S. Rose, senior vice president and chief financial officer of Southern NH Health System based in Nashua and Robert Steigmeyer, president and CEO of Capital Region Health Care and Concord Hospital in Concord.

For more information, visit granitehealth.org.