Harvard Pilgrim is…
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Harvard Pilgrim is a non-profit health plan located in Massachusetts. We’re licensed to sell and service health insurance solutions in Massachusetts, New Hampshire and Maine. We also have an expansive physician and hospital network in Rhode Island, which supports some members who get their coverage in Massachusetts, but receive their health care in Rhode Island. We have about 1 million members (over 1 million, actually), most of whom live in Massachusetts, but we’ve also got about 50,000 members in Maine and another 100,000+ members in New Hampshire.We’ve won a number of awards over the years for member satisfaction and clinical effectiveness, and U.S. News & World Report gave us their #1 ranking for two years in a row in their annual survey of the best health plans in the country. More recently, J.D. Power and Associates published its rankings on the best health plans in the country, and Harvard Pilgrim finished first in the Northeast (with 785 points out of a possible 1,000), and also generated the highest overall score in the country. That ranking was based on a combination of things – benefit plan design, customer service, network size and access, approval processes, information and communication, insurance statements and claims processing expertise, to name a few. Since J.D. Power is one of the nation’s best and most well known analyzers of corporate performance and customer satisfaction, it was extremely gratifying to us all that they thought we were among the best of the best. That said, we’re always looking for opportunities to improve (hint, hint).
I am curious to know what it will take for HPHC to return to the Rhode Island marketplace and become competitve with Blue Cross Blue Shield of Rhode Island?
Mark - We didn’t do too well when we competed in Rhode Island before. I don’t know if you know or recall this, but we used to be a pretty decent sized participant in the Rhode Island marketplace. We had about 200,000 members who lived in the Ocean State, and operated several health centers there. We basically lost money in Rhode Island throughout the last half of the 1990’s competing against BC/BS of RI, and ended up in receivership in late 1999. The Rhode Island Department of Business Regulation then liquidated our business. Virtually everyone ended up getting paid - which was good - and most people were able to transition their insurance coverage to either United or BC/BS of RI (at much higher prices, I might add) - which was also good. But we learned a valuable lesson. If you don’t have a lot of money to “invest” in growing market share in a state you’re not already in, doing so can be very, very expensive. Too much so for us.
I doubt you’ll see us in Rhode Island anytime soon, but in the meantime, we do partner with United Health Care to offer products that cross state lines between MA and RI, which for many customers, can be a pretty good alternative to BC/BS of RI.