HMO Membership In Mass. Dives By 3 Percent In Q1 | Worcester's FCHP one of three HMOs to see membership growth
PHOTO/COURTESY
Patrick Hughes, FCHP's president of health plan operations.
PHOTO/COURTESY
Patrick Hughes, FCHP's president of health plan operations.
Only three of the 10 health maintenance organizations offering health care coverage to Massachusetts residents saw membership increases from the fourth quarter of 2007 to the first quarter of this year, according to a report from the Massachusetts Division of Insurance.
Total HMO membership in the state was down a disappointing 3 percent after steady gains the previous three quarters.
Roll Call
The biggest winner of the first quarter in terms of membership growth was Neighborhood Health Inc., whose membership rose from 172,864 to 179,747, or by 3.98 percent. Tufts Associated HMO Inc. also reported a 2 percent increase, with membership now at nearly 328,000.
Worcester-based Fallon Community Health Plan Inc., saw its membership increase to 162,091, a jump of 2.4 percent. According to one FCHP official, the growth is due to several factors.
âGrowing into other areas and being a new kid on the block and bringing our products and solutions to this new geography is part of it,â said Patrick Hughes, FCHP's president of health plan operations.
FCHP has expanded west from Worcester into Springfield and the Berkshires, east into MetroWest, Middlesex County and the Merrimack Valley, as well as south into the New Bedford area, he said.
The slower economy has also caused businesses and individuals to take a harder look at alternative carriers, he said. Working with medical partners who effectively manage medicine helps FCHP keep costs down, making its HMOs less expensive and more attractive, he said.
FCHP sees the state's insurance mandate that everyone must have health care insurance as an important growth opportunity, and will continue to develop new products and markets as the year progresses, Hughes said.
Watertown-based Tufts attributes its growth to continually rising medical costs and the relationships it builds with insurance distributors and the employers that buy group plans, according to Brian Pagliaro, Tufts' senior vice president of sales and client services.
Tufts has grown its membership every quarter since the first quarter of 2006, and is confident the rest of the year will also see more members, he said. Tufts focuses on keeping health care costs down so it can keep premiums down, which also attracts members, he said.
On The Decline
Blue Cross and Blue Shield of Massachusetts HMO Blue Inc., Harvard Pilgrim Health Care Inc. and Aetna Health Inc. saw membership reductions of 5.85 percent, 6.41 percent and 13.63 percent respectively.
For Blue Cross and Blue Shield, that percentage translates to a drop of 50,614 members. In the company's first quarter financial 2008 report, it reported a loss of 17,000 loss in its HMO membership after Gillette was acquired by Ohio-based Proctor & Gamble.
Many Gillette members are enrolled in Anthem BCBS in Ohio, although Blue Cross and Blue Shield of Massachusetts will continue to serve as the host plan for 4,765 members that are Massachusetts-based Proctor & Gamble employees. While many other Blue Cross and Blue Shield organizations across the country have been bought by Anthem over the last few years, the one in Massachusetts is independent.
At Harvard Pilgrim the 6.41 percent decline between quarters means a loss of 23,268 members, and for Aetna the 13.63 percent meant a loss of 530 members.
Despite its membership drop in the first quarter, Blue Cross and Blue Shield and Harvard Pilgrim still have big shares of the state's health care insurance market, 42.8 and 17.9 respectively, according to the state's Division of Insurance.
In Worcester County, Blue Cross and Blue Shield and FCHP are the two most subscribed HMOs for the first quarter of 2008, with 101,164 and 125,715 members respectively, and Harvard Pilgrim a distant third with 35,794 members. ConnectiCare and UnitedHealthcare of New England both had roughly 50 members in Massachusetts.
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