BOSTON – Thousands of patients at Boston Children’s Hospital, UMass Memorial and Tenet hospitals may need to find new doctors after the hospitals failed to come to an agreement with the second-largest health insurer in Massachusetts, Point32Health.
Who is impacted by the change?
The change primarily impacts those on Tufts Health Direct, a subsidized program that is offered through the state’s Health Connector. Point32Health owns Tufts Health Plan and Harvard Pilgrim Health Care.
All affected members received letters on Tuesday notifying them of the changes, which will impact more than 20,000 patients.
No agreement with Children’s or UMass
According to Point32Health, it was unable to reach an agreement with UMass Memorial Health and Boston Children’s Hospital for Tufts Health Direct members.
“These providers determined that for one product, Tufts Health Direct, they cannot accept the rate necessary to offer affordable coverage to these individuals who receive premium support due to low income. It is our responsibility as a Commonwealth to ensure affordability of these products for this population,” Point32Health said in a prepared statement.