Tufts entering R.I. Medicaid market

CRANSTON – Tufts Health Plan, which is new to the Medicaid market in Rhode Island, is one of three health plans, along with Neighborhood Health Plan of Rhode Island and UnitedHealthcare Community Plan, that have signed contracts with the state to pay for health care services for Rhode Island’s Medicaid population.

The news was announced Thursday by the state Executive Office of Health and Human Services.

Contracts are effective for five years with five optional one-year extensions, according to the state agency.

“With our mission to improve the health and wellness of the diverse communities we serve, the opportunity to serve more Rhode Island residents is exciting for us,” Tom Croswell, president and CEO of Tufts Health Plan, said in a statement. “We look forward to working with Governor Raimondo and the state to support their efforts to improve Medicaid in Rhode Island. It’s our intent to offer a Medicaid plan that provides excellent value and service.”

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With the addition of Tufts Health Plan, the 250,000 Medicaid-eligible Rhode Islanders now have a choice of three health plans.

The state expects to hold an open enrollment period this summer to allow Medicaid members the option to stay in their current health plan or switch plans.

Rhode Islanders new to Medicaid can choose Tufts Health Plan, called RITogether, for coverage that begins on June 1.

Tufts Health Plan spokeswoman Kathleen Makela said the expansion in Rhode Island will bring 64 new jobs across the state, with roles ranging from care managers and other clinical staff to provider and customer service representatives, and a plan to move into bigger offices. She said Tufts has about 12 employees based in Rhode Island who support the company’s commercial business. Tufts currently is at 1 West Exchange St.

Patrick M. Tigue, Rhode Island’s Medicaid director, called the addition of Tufts “great news for Rhode Island,” as it gives Medicaid members another option regarding their choice of provider, adding “we are fortunate to have longstanding relationships with Neighborhood and UnitedHealthcare.”

Since 1994, Rhode Island has contracted with Neighborhood Health Plan of Rhode Island and UnitedHealthcare Community Plan, EOHHS said.

All three health plans are highly rated by the National Committee on Quality Assurance and have ranked among the top Medicaid health plans in the country for many years, the state agency said.

Tufts Health Plan offers employer-sponsored health plans in Rhode Island, Massachusetts and New Hampshire, as well as Medicare, Medicaid and Marketplace plans in Massachusetts.

Currently, Neighborhood’s membership represents approximately 66 percent of the total Medicaid managed care population in Rhode Island, with UnitedHealthcare representing 33 percent.