harvard pilgrim health care


Harvard Pilgrim Chief To Chair National Health Insurers’ Group

Eric Schultz, the chief of Harvard Pilgrim Health Care, is donning a mantle of national prominence in the health insurance world, as the newly elected chair of the board of directors of the trade association America’s Health Insurance Plans. AHIP says its members provide health and supplemental benefits to more than 200 million Americans.

From an AHIP press release:

Schultz has more than 26 years of health care experience. Prior to joining Harvard Pilgrim in March 2010, Schultz was president and chief executive officer of Fallon Community Health Plan (FCHP) for ten years. Schultz also held executive positions with CIGNA Healthcare, Prudential Healthcare, and served as Medical Group Administrator for Nashville Healthcare Group.


“I am honored to be elected as the new Chair of the Board of Directors. AHIP has long been a strong advocate for a balanced approach to health care reform. As the new Chair, I will lead our charge to help ensure all Americans have access to care and to identify and address the root causes of our nation’s medical cost and quality challenges. We must pursue truly systemic solutions if reform is to be successful,” said Eric Schultz.

Eric talks about some of those very issues in the video above. I’d been hesitant about posting it, because it’s an unaccustomed situation: Harvard Pilgrim itself shot the video of my get-acquainted interview with Eric a few months ago, and then posted it as part of its own Let’s Talk Health Care. Also, frankly, I doubted whether many readers would really want to watch a long chat about health insurance.

But now, given Eric’s new national position, I figure the footage may offer some useful insights into the directions his AHIP leadership could take. And for the hard-core wonk faction, there are three more video chunks of the interview up on YouTube here, here and here.

MA Health Insurance: Putting Off The Premium Pain?

Don’t miss this excellent report on Massachusetts premium hikes this morning by WBUR’s Martha Bebinger, coming on the heels of yesterday’s daunting national figures from the Kaiser Family Foundation:

WBUR's Martha Bebinger

BOSTON — You would think word that health care premiums won’t go up as much next year would be a reason to celebrate. Health insurers are certainly relieved to have some moderately good news.

“The average rate of premium increases that our customers will experience will be the lowest level since 2005,” said Blue Cross Blue Shield Vice President Jay McQuaide.

Blue Cross is telling medium to large firms their premiums will increase 4 to 6 percent. At Tufts Health Plan the range is a five to 8 percent rise and at Harvard Pilgrim Health Care it’s a 5 to 10 percent increase. Keep in mind that employers will have higher and lower increases depending on the type of plan they buy and how much care employees used in the recent past.

These rates are down a few points from last year, but they are still climbing much faster than the expected inflation rate of 1.6 percent in Massachusetts.

“Premiums are still increasing at a rate that is neither acceptable nor sustainable,” said McQuaide, “and we know here at Blue Cross that we’ve got more work to do to make health care affordable.”

You’ll hear that “more work to do” message from Harvard Pilgrim and Tufts as well. The plans are under increasing pressure from employers, consumers and the state to reduce premiums.

Martha reports on the debate on whether the state should regulate insurance rates more, including this vivid quote:

“Those rates are nothing less than big neon lights flashing legislative solution, legislative solution, legislative solution and we can’t ignore it anymore,” said the Rev. Hurmon Hamilton, with the Greater Boston Interfaith Organization (GBIO). GBIO and Health Care for All had called on insurers to freeze premiums for one year, a call insurers said was unrealistic.

AG Coakley on Health Insurer Merger: We’re On It

AG Martha Coakley

This morning, WBUR’s Curt Nickisch was at the Greater Boston Chamber of Commerce breakfast where Attorney General Martha Coakley spoke. He reports:

Coakley says she’s already reached out to two of the state’s largest health insurers, who say they’re exploring a merger. Harvard Pilgrim Health Care and Tufts Health Plan say joining forces will help them cut administrative costs and save consumers money. But any merger would first have to be approved by the AG. And Coakley told Boston business leaders this morning that her office is already looking at the anti-competitive issues of removing a major player from the state’s health insurance market.

“Our role should be to identify early on for the two parties involved issues that we see,” she said. “Can we address them? We’re not going to sit by the sidelines, wait until the merger, and then jump out and say, ‘Hey, you guys can’t do this!“ because of something. We want to be active and involved going forward. And we are keeping an open mind about it.

The state’s Division of Insurance also has to approve any merger.

Study On Harvard Pilgrim High-Deductible Plan: Even Better-Off People Scrimp

Yes, indeed. When you have a high-deductible health insurance plan, in which you have to pay the first $1,000 or $2,000 in health care costs, you tend to scrimp on care, much like, well, an uninsured person.

High-deductible plans are growing quickly in popularity these days, and are expected to grow still faster as federal health reform kicks in. But a new study of Harvard Pilgrim Health Care patients suggests that, as NPR’s Julie Rovner puts it here, high deductibles may be bad for your health.

The Los Angeles Times lays out the study:

The team, from the University of Pennsylvania and Harvard, surveyed 434 families enrolled in high-deductible health plans offered by Harvard Pilgrim Health Care, a nonprofit health insurer in New England. High-deductible plans were defined as those with annual deductibles of at least $1,000 for individuals and at least $2,000 for families.

Fifty-seven percent of lower-income families reported they had delayed or foregone treatment because of cost, versus 42% of higher-income families, the study reported. Continue reading

Squeaker in Mass. Health Plan Ratings

You may not feel yourself overflowing with love and appreciation as you pay your premium, but the fact is that several Massachusetts insurance plans are considered excellent — in fact, tops. (Our premiums also tend to be higher than elsewhere, by the way.) Massachusetts dominated the top ten in the latest national rankings that the non-profit National Committee for Quality Assurance issued. The top of the rankings looked like this:

1. Harvard Pilgrim Health Care

2. Tufts Associated Health Maintenance Organization

3. Harvard Pilgrim Health Care of New England

4. Capital Health Plan

5. Geisinger Health Plan

6. Grand Valley Health Plan

7. Group Health Cooperative of South Central Wisconsin

8. Fallon Community Health Plan

9. Kaiser Foundation Health Plan of Colorado

10. Health New England

11. Blue Cross and Blue Shield of Massachusetts

All the top-rated Massachusetts plans are non-profits. And just a bit of inside baseball: If you look at the complete list here, you’ll see that Harvard Pilgrim edged out Tufts for the top spot by just a hair: an overall ranking of 90.5 vs. 90.4. Last year’s scores followed a similar pattern, and the two plans have been neck-and-neck at the top for five years now. Readers, what do you think is up?

Patrick Vs. Baker on Harvard Pilgrim Record

Gubernatorial candidates (and moderator Jon Keller, center)

In last night’s gubernatorial debate, health care and its ever-escalating costs were a central point of contention. WBUR’s Martha Bebinger reports:

The candidates focused on rising health care costs several times during the debate. Patrick tried to pin the problem on Baker, who ran Harvard Pilgrim Health Care before leaving to campaign for governor.

“Health care costs are the single biggest concern of businesses, it’s what I hear everywhere, and you’ve been at the center of that. You’ve raised premiums 150 percent,” Patrick says.

Baker points out that Harvard Pilgrim was even with, or less expensive than other private insurers during his tenure.

“Harvard Pilgrim grew by 45 percent over the last seven years I was there because our premiums were priced competitively, but there were a lot of issues with regard to the rules, regs and requirements that haven’t solved the health care problem in Massachusetts and most of those rest with state government,” he says. Continue reading