Tufts Health & Harvard Pilgrim Say Merger Will Save

Following their merger in January, Harvard Pilgrim Health Care and Tufts Health Plan, both of which have offices in NH, anticipate more than $100 million in savings by consolidating administrative functions that they say will offset premium increases and members' out-of-pocket burden.

The two organizations, which are headquartered in Massachusetts formally combined on January 1, 2021, having received regulatory approvals. For the time being, however, Tufts and Harvard Pilgrim will continue to operate as separate companies, keeping their current respective company names. A new name for the combined company is expected in the next few months.

The NH Insurance Department annual report issued in Dec. 2020 (for insurance companies operating in the state) saw Tufts’ NH-based plan, Tufts Freedom Health Plan, gain market share in the small group market in 2019. Tufts had 21% of the market, up from 5% in 2017, while Harvard Pilgrim had a loss of market share. In the large group, Tufts’ gained 1% in market share and Harvard remained the same.

The new combined organization will serve 2.4 million members and remain a nonprofit across New England, providing health coverage in every segment of the market.

“This combination brings together the expertise of two great companies with rich legacies, and strongly preserves nonprofit health insurance coverage in our region,” said Tom Croswell, CEO of the new combined organization. Croswell formerly served as president and CEO of Tufts Health Plan and has announced that he will be retiring. “We will build upon our unwavering commitment to serve the needs of our diverse communities and our members, regardless of age, health, race, identity or income.”  

According to a statement, the new organization’s commitments to its stakeholders are:

• To provide access for all that work regardless of a person’s age, health, race, identity, or income.
• To develop pace setting innovation, that looks beyond the status quo to bring together partners and perspectives for ideas that solve health care’s challenges.
• To better the customer experience by making them simpler, smarter, and more seamless than the day before.
• To provide better health navigation so members and communities can find their best version of health and wellness. With behavioral health an integral part of overall health, prioritizing the integration of medical and behavioral health management is a priority for the new organization.

An immediate area of focus is the coronavirus pandemic and the combined firm will invest $1 million to support education, awareness and outreach related to the vaccine, especially in Black and Brown communities, where the virus has had a disproportionate effect. This investment is in addition to the over $10 million already committed by both organizations, as well as the Tufts Health Plan Foundation and The Harvard Pilgrim Health Care Foundation, to advance pandemic recovery and racial justice. 

The combined organization, its foundations and the Harvard Pilgrim Health Care Institute will collaborate on this pandemic response to achieve the greatest community impact, building upon critical initiatives already in place. The new organization is developing its long-term strategy and investment plans related to health equity, behavioral health, complex care management and telehealth.

“Built on the strong foundation and history of both organizations, Harvard Pilgrim and Tufts Health Plan bring together two of New England’s leading and innovative nonprofit health services organizations with decades of dedication to serving their members and communities,” said Michael Carson, president of the combined organization and previously president and CEO of Harvard Pilgrim. “We are excited and eager to start this journey as one organization with a vision of transforming how health care is accessed, aligning a fragmented system and guiding our members and communities to better health and a better health care experience.”

The new headquarters will be in Canton, Mass., while NH offices will remain in Manchester.