Health reform is fueling strong growth at NHP

SETTING A PLAN: From left: Neighborhood Health Plan of Rhode Island CEO Peter M. Marino, Vice President Brenda Seagrave-Whittle and member advocate Jacqueline L. Dowdy. / PBN PHOTO/MICHAEL SALERNO
SETTING A PLAN: From left: Neighborhood Health Plan of Rhode Island CEO Peter M. Marino, Vice President Brenda Seagrave-Whittle and member advocate Jacqueline L. Dowdy. / PBN PHOTO/MICHAEL SALERNO

Leaders of Neighborhood Health Plan of Rhode Island say strong growth of the company’s patient base, staff and revenue highlight growing community needs prioritized by nationwide health care reform.
The Providence-based nonprofit, which has provided insurance for recipients of Medicaid’s managed-care programs for 20 years, has more than doubled revenue since 2013, increased its patient base by 45 percent in the same time frame and plans to create another 100 new staff positions by the end of 2015. The company largely attributes its rapid growth to expansion into new populations of Medicaid recipients, according to spokesman Tom Boucher.
NHP is also making changes to the prices and plans of its commercial offerings, which it only took to market last year as part of Rhode Island’s state-based health care exchange.
“I think that demonstrates that we are a business that is flourishing right now, and that’s interesting given the mission of Neighborhood and the drive that we’re trying to achieve – quality health care for at-risk populations,” said CEO Peter Marino, former director of the R.I. Office of Management and Budget, who joined the company in September.
Neighborhood was founded in 1993 by a group of nonprofit community health centers to provide insurance to Medicaid enrollees. At its inception, the organization’s operations were handled by Neighborhood Health Plan of Massachusetts, and its first members, in 1994, were pregnant women and children up to 6 years old who were enrolled in Medicaid’s RIte Care program.
Over the next 20 years, the organization expanded its offerings incrementally, Boucher said.
By the time Neighborhood Health Plan of Rhode Island took over its own operations in 1998, it was serving children up to age 18 through RIte Care.
Over the next several years, NHP expanded its offerings to serve foster children in the care of the R.I. Department of Children, Youth & Families; children with special health care needs, and adults with disabilities who are Medicaid-only eligible. Today, NHP maintains about 64 percent of Medicaid’s managed-care programs in Rhode Island.
In 2013, NHP started taking on dually eligible adults who qualify for both Medicaid and Medicare. The move proved to be a vehicle for massive expansion; by the next year, revenue more than doubled, from $439 million at the end of 2013 to $890 million at the end of 2014.
A dually eligible adult is typically eight to 10 times more expensive to serve than the average Medicaid patient, which accounts for the 103 percent spike in revenue, according to Boucher. Serving dually eligible adults has expanded more than NHP’s bottom line – the company has also added 80 staff positions in the past year. It expects to employ 405 by the end of this year and 515 by the end of 2015. Most of the new hires will provide ancillary services aimed at the dually eligible population – nurses, social workers, community-outreach workers and customer-service representatives.
“It’s certainly an investment,” Marino said. “This population is one that requires a very hands-on approach.”
In the past year, NHP also made its first foray into the private market by offering plans to individuals and small businesses via HealthSource Rhode Island.
During NHP’s first year on the exchange, its enrollment numbers weren’t particularly impressive, according to figures released in a report by the Rhode Island Public Expenditure Council. In the individual market, only 3 percent of the 26,686 people enrolled as of Aug. 2 chose NHP plans, while Blue Cross & Blue Shield of Rhode Island took the rest. In the exchange’s small-business program, only 1 percent of enrolled companies chose NHP plans. “Part of our strategy this year as we approached this second year of being in this was really wanting to offer a few more plans, as well as trying to position ourselves to be the lower-priced health plan,” said Brenda Whittle, NHP’s chief marketing officer and exchange vice president. “And all of those things so far have happened.”
NHP added four plans to its commercial offerings on HealthSource RI for the coming year – new bronze and silver plans for both the individual and small-business markets.
NHP was also the only insurer in Rhode Island to request a reduction in its base rate for 2015, although data presented by a September report from the McKinsey Center for U.S. Health System Reform indicated that, nationwide, price reduction wasn’t uncommon this year because of the uncertainty insurers faced moving into the exchange marketplace.
NHP’s marketing campaign has shifted to reflect the company’s new offerings, Whittle said.
“We have been a traditional Medicaid program for the last 19 years, and so this year particularly, we really changed how we’re advertising, what we look like out there and the audience we’re going after,” she said. “If you looked at our ads two or three years ago, we had a lot of kids in our ads, a lot of moms in our ads. Now we’ve opened up our advertising to look like the entire lifespan … instead of just a traditional Medicaid population.”
NHP may also be taking on additional behavioral-health services through Medicaid, starting in the late spring or early summer of 2015.
“Taking on these additional responsibilities, it’s going to take some time to make sure we’re doing it right,” Marino said. “We’re going to invest our time and make sure we have the right people [and] technology in place.” •

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