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Medicaid population whomps Partners’ results

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Part of Partners’ Brigham and Women’s Hospital.

As is often the case, Medicaid populations pose big financial challenges.

Consider prestigious Partners HealthCare, which owns Massachusetts General Hospital, Brigham and Women’s and some other famed hospitals.  It had a  record $108 million operating loss and a $249 million net loss in fiscal 2016. Most of the operating loss came from Neighborhood Health Plan (NHP),  its insurance unit that primarily serves low-income people. It’s the biggest loss in the system’s history.

NHP provides coverage for more than 430,000 commercial and Medicaid members; it’s the largest Medicaid insurer in Massachusetts.

NHP has been quite a challenge, having had $322 million in losses in the past three years. So Partners is taking such actions as closing  enrollment to new Medicaid members to give it time to renegotiate the rates it pays some hospitals.

Partners’ income was also hurt by the very expensive preparation for a nurses strike that was averted at the last moment and the continuing expense of a new $1.2 billion Epic EHR system.

To read more, please hit this link.


Partners’ Medicaid unit freezes enrollment

 

Neighborhood Health Plan, a unit of Boston-based PartnersHealthCare, has stopped accepting new Medicaid members after losing $241 million since 2014. It’s a sign of how hard it can be to serve low-income residents, especially  in  Massachusetts, which has  among America’s highest healthcare costs.

Neighborhood,  the largest Medicaid insurer in the Bay State, temporarily froze enrollment as part of a “corrective action plan” developed with state health officials.

The  decision will reduce insurance options for  low-income families who qualify for Medicaid — the joint federal-state program,  which is called MassHealth in Massachusetts. Neighborhood is the only MassHealth plan that gives members access to the state’s most renowned teaching hospitals, Massachusetts General and Brigham and Women’s, which are also owned by Partners.

To read The Boston Globe story on this, please hit this link.


Partners names VP for population-health finance

 

In a sign of the rapidly growing importance of population health, Boston-based Partners HealthCare and its insurer, Neighborhood Health Plan, have created a new position: vice president for  population-health finance.

Douglas Thompson will be the first executive to oversee population-health finance operations for both Partners and NHP. He is to provide leadership on care integration and in promoting new population-health models, including payment mechanisms and investments.

Mr. Thompson has been chief financial officer  for Neighborhood Health Plan since 2014, a position he will retain in addition to his new job.


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