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Company Profile

At Tufts Health Plan, we strive to set the standard for outstanding quality health care, service, and value.

Corporate Profile

Founded in 1979 as a not-for-profit health maintenance organization, Tufts Health Plan is one of the nation’s most highly-rated health plans. The company is distinguished for providing an outstanding member experience and access to quality care. Tufts Health Plan offers a broad array of health care coverage options to individuals and employer groups. Through diverse product offerings, the plan covers members regionally and across the country. Its tagline —“No one does more to keep you healthy”—expresses a core commitment to offering plan members innovative tools and resources that engage them in enhancing their health and well-being, and managing health care costs.

Tufts Health Plan is a leader in advancing public policy discussions on several issues: prevention and wellness, affordability, and removing obstacles to accessibility.

Mission

To improve the health and wellness of the diverse communities we serve

Vision

Every life improved through access to high-quality, affordable health care

Products & Services

From traditional HMO and PPO plans to national, tiered and limited network plans, Tufts Health Plan provides quality health care coverage across the spectrum of an individual’s needs.

Quality Performance

Tufts Health Plan is currently ranked the #1 private health insurance plani and the #1 Medicaid health insurance planii, known as Network Healthiii, in the country by the National Committee for Quality Assurance’s (NCQA) Health Insurance Plan Rankings 2014-2015. This recognition represents the first time that a health insurance company has been ranked #1 in more than one category by the NCQA.

In 2013, Tufts Health Plan’s commercial Health Maintenance Organization/Point-of-Service Option (HMO/POS) combined product was ranked No. 6 in the nation and its commercial Preferred Provider Organization (PPO) plan was No. 8 by the NCQA. This is the 10th consecutive year that Tufts Health Plan has been ranked among the top health plans by NCQA*.

Since 1999, these products have achieved the highest possible accreditation status from NCQA for consumer protection, quality improvement and clinical effectiveness.

In its quality ratings analysis, the Center for Medicare and Medicaid Services (CMS), reviewed 45 unique quality metrics to award Tufts Medicare Preferred HMO plans 4.5 out of 5 stars for 2014. This ranking puts the plan among the top five percent of Medicare Advantage plans nationwide.

Network Health is the nation’s No. 3 ranked Medicaid plan according to the NCQA*. 

iHMO/POS plans. NCQA’s Private Health Insurance Plan Rankings 2014–2015. Tufts Associated Health Maintenance Organization is the formal name for Tufts Health Plan’s HMO/POS products.

iiNCQA’s Medicaid Health Insurance Plan Rankings 2014–2015.

iiiNetwork Health is Tufts Health Plan’s Medicaid/public plans division.

*NCQA’s Health Insurance Plan Rankings 2013-14 – Private and Medicaid

Corporate Citizenship

Founded in 2008, the Tufts Health Plan Foundation’s external link mission is to promote healthy lifestyles and deliver quality health care in our communities. The foundation’s focus is Healthy Aging—improving the lives of adults aged 60 and older. The foundation funds more than $2 million annually in grants to nonprofit organizations throughout Massachusetts and Rhode Island that elevate the well-being of older adults and help them live healthier lives.

For eight consecutive years, the U.S. Environmental Protection Agency has awarded Tufts Health Plan the ENERGY STAR label for superior energy performance at its Watertown headquarters. Tufts Health Plan was the first health care organization in New England to earn the ENERGY STAR label. Tufts Health Plan also has earned the Best Workplace for Commuters designation from the EPA.

In November 2013, Tufts Health Plan was ranked No. 7 among participating large Massachusetts employers in The Boston Globe Top Places To Work and was the highest-ranked health insurance organization in the survey. In June 2013, Tufts Health Plan earned a Best Employers for Workers Over 50 award from AARP and the Society for Human Resources Management. Tufts Health Plan received the Leaders in Diversity award from the Boston Business Journal in October 2011 for building a diverse workforce that is reflective of the communities it serves.

President and Chief Executive Officer

James Roosevelt, Jr.

Founded

In 1979 by Morton Madoff, M.D., dean (emeritus) of Tufts University School of Medicine

Operational Date

1981

Network

90 hospitals and some 25,000 health care providers

Membership

Current membership: 998,865 (December 31, 2013)

Net Worth

$1 billion (December 31, 2013)