Helene Forte | Vice president, public plans emerging markets, Tufts Health Plan
1. Why did Tufts Health Plan want to enter R.I.’s Medicaid market? As a nonprofit health plan, whose mission is improving health and wellness in the diverse communities we serve, we [had] wanted to expand our presence in Rhode Island for some time. … We’re excited to offer health care coverage not only for employers but also to Medicaid users. We feel strongly that our Medicaid plan will change the way many Rhode Islanders view their health plan and how they benefit from it. We feel we can make a difference.
2. What will your presence be in Rhode Island? We’re relocating to [Providence] to support our growing presence and provide easy access for members across the state. We hired 25 new employees, all based in Rhode Island, to support our Medicaid entrance [and] that number will grow with our membership.
3. How do you envision being aligned with the governor’s Reinventing Medicaid plan? We fully support work by Gov. Gina M. Raimondo to improve Medicaid in Rhode Island. Value-based health care and coordination of care is in Tufts Health Plan’s DNA. … The governor’s Reinventing Medicaid goals are fully aligned and consistent with our approach.
4. How does the uncertainty in Washington on the future of Medicaid influence your strategy? Risk is always there, it’s how you manage it that’s critical. Building a sound business strategy also includes being keenly aware of the policy environment that might affect our work. We are attuned to the uncertainties stemming from Washington and are speaking with our congressional delegations and other regulators about the importance of providing coverage for vulnerable populations. We see no reason to lessen our 20-year commitment to serving … Medicaid populations.
5. What differentiates Tufts from other choices available to Rhode Island’s Medicaid beneficiaries? As a nonprofit, regional health plan, we are big enough to invest in best practices, technology and innovation, but small enough that most senior leaders [work with] the governor and other regulators. Unlike other Medicaid plans in Rhode Island, we do not outsource our behavioral health programs to external vendors. Our teams also include social care managers who address the housing, clothing or food needs of our members.