Harvard Pilgrim launches limited provider network in Massachusetts

WELLESLEY, Mass.—Harvard Pilgrim Health Care Inc. is partnering with dozens of Massachusetts hospitals and more than 16,000 physicians to offer a new provider network that the company says could reduce employers' premium rates by as much as 10%.

The new provider network, Focus Network-MA, will be available with a range of Harvard Pilgrim health maintenance organization plans, including its Best Buy deductible plans, according to a statement from the Wellesley, Mass.-based health insurer.

Harvard Pilgrim said the new limited provider network, which excludes some of the state's higher-cost health care providers, would lower employers' premiums by 8% to 10% compared with its full-network plans without reducing employee benefits or coverage or increasing employee cost-sharing.

Focus Network-MA will provide employers and their workers with access to 16,500 physicians and 52 hospitals in the state, Harvard Pilgrim said, including Beth Israel Deaconess Medical Center, Boston Medical Center, the Dana-Farber Cancer Institute, Lahey Clinic Hospital, New England Baptist Hospital, St. Elizabeth's Hospital, Tufts Medical Center and Tufts Floating Hospital for Children.

Pending regulatory approval, Harvard Pilgrim said the new provider network would be available beginning April 1 throughout most of Massachusetts and in select cities and towns in neighboring states. Plan members would only be covered for in-network providers, according to the company.

“By including those providers that are of the highest quality and cost efficiency, Focus Network-MA brings real cost savings and lower premiums without reducing benefits and coverage or shifting the cost to the consumer,” said Harvard Pilgrim President and CEO Eric Schultz in a statement.

Harvard Pilgrim said the Focus Network-MA plans can be purchased as stand-alone policies or paired with full-network plans on a “side-by-side” basis. Similar to its full-network plans, the Focus Network MA offerings include access to health services and wellness programs and online resources, as well as an exclusive member services unit to facilitate the transition into the program.