Largest Medicaid insurer in Mass. stops taking new members
Neighborhood Health Plan (NHP), a Medicaid managed care subsidiary of Boston-based Partners Health Care, is suspending enrollment of new members after $241 million in losses since 2014.
According to the Boston Globe, the freeze is part of a “corrective action plan” for the largest of the six insurers Massachusetts pays to manage care for patients on Medicaid, known as MassHealth in the state.
“Despite making progress in controlling total medical expenses, Neighborhood Health Plan continues to experience material losses in the MassHealth program,” spokeswoman Pam Jonah said in a statement to the Globe. “We evaluated many options to address our financial challenges with the MassHealth program and determined that the temporary enrollment freeze would ensure the least disruption.”
While the approximately 300,000 existing members won’t be affected, new members would be cut off from access to top Partners hospitals Massachusetts General and Brigham and Women’s, which aren’t included in other MassHealth managed care plans.
For more on how Partners fears NHP’s association with Medicaid hurts its more profitable commercial business, click on the link below:
John joined TriMed in 2016, focusing on healthcare policy and regulation. After graduating from Columbia College Chicago, he worked at FM News Chicago and Rivet News Radio, and worked on the state government and politics beat for the Illinois Radio Network. Outside of work, you may find him adding to his never-ending graphic novel collection.