Health insurers Tufts, Harvard Pilgrim to merge
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Harvard Pilgrim Health Care's Wellesley headquarters
Tufts Health Plan and Harvard Pilgrim Health Care on Wednesday announced plans to combine their two organizations into a new company that will serve nearly 2.4 million members in Massachusetts, Maine, Connecticut, New Hampshire and Rhode Island.
The new organization has not yet been named, and company officials have not said where it will be based — Harvard Pilgrim is headquartered in Wellesley and Tufts in Watertown. The deal is subject to various state and federal approvals, and the two companies will remain independent during the approval process.
The deal amounts to a significant consolidation in the Massachusetts health care insurance market, with two of the largest insurers joining forces and creating a single, larger rival to the state's biggest insurer, Blue Cross Blue Shield of Massachusetts. Policyholders and consumers will be on the lookout for impacts on them, and the agreement will be also be vetted by government regulators.
The state's top three commercial payers — Blue Cross Blue Shield of Massachusetts, Harvard Pilgrim and Tufts — account for nearly 62 percent of the private health insurance market membership, according to a Center for Health Information and Analysis report that used September 2018 data.
Blue Cross Blue Shield is by far the largest by membership, according to the report, with 1.6 million members in Massachusetts to Harvard Pilgrim's roughly 500,000 and Tufts' roughly 360,000.
Worcester-based Fallon Health reported 264,000 members in May.
In a joint statement, Tufts and Harvard Pilgrim said the combined organization "will be even more effective, better able to keep high-quality health care accessible and affordable, while at the same time investing in programs and initiatives that enhance quality."
Tufts Health Plan President and CEO Tom Crosswell will serve as CEO, and Michael Carson, currently the president and CEO of Harvard Pilgrim, will serve as president. Both organizations will be equally represented on a board of directors chaired by Joyce Murphy, who now chairs the Harvard Pilgrim board.
"Our communities and consumers today face four major hurdles in health care: affordability, access, quality of health and a fragmented health care experience across various stakeholders and health systems," Croswell said in a statement. "Through our shared vision, we believe we can tackle these issues and bring more value to the communities we serve."
Meggie Quackenbush, a spokeswoman for Attorney General Maura Healey, said Healey's office has been in touch with both insurers and "will review the proposed transaction as more information becomes available."
Though the state's Health Policy Commission has analyzed other major health care mergers, like the transaction that recently created the new Beth Israel Lahey Health, the commission does not have the authority to review a merger between two health plans.
HPC spokesman Matthew Kitsos said the commission looks forward to learning more about the deal that "could have a significant impact on the Massachusetts health care market."
Last year, Harvard Pilgrim had been exploring a merger with Partners HealthCare, the largest health system in the state.
The Tufts/Harvard Pilgrim deal was approved unanimously by both organizations' boards, the companies said.
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