Tufts Health Plan

What it reported doing in 2024

Detail of program service accomplishments - Massachusetts medicaid mco and aco plans tufts health together is the name of the organization's Massachusetts medicaid mco and aco plans that provide access to affordable health care for qualified residents and their families who meet income and other eligibility requirements. Masshealth is the name of the Massachusetts medicaid program funded by the federal government and the state. Masshealth helps people with limited incomes and resources pay for medical and support services. It also covers extra services and drugs. The organization provides access to affordable health care through a medicaid managed care organization contract with the Massachusetts executive office of health and human services for qualified residents and their families who meet income and other eligibility requirements. Thpp was awarded two medicaid accountable care organization contracts by eohhs in addition to its existing managed care organization contract. Through contracts with two Massachusetts-based provider systems, the organization provides medicaid managed care closely aligned with primary care physicians and community partners. Tufts health together provides low to moderate income individuals with access to thousands of high quality primary care doctors and specialists across the state, supportive service representatives, information in a number of languages, as well as preventive measures such as car seats and fitness bands, incentives for healthy behaviors, gym fee reimbursements, and other important tools to promote health and wellness. Ncqa health plan accreditation and health plan rating evaluate health plans' structure and process, clinical quality and patient satisfaction. Tufts health public plan's together medicaid product maintains ncqa health plan accreditation and has consistently received high scores based on ncqa's health plan rating methodology and achieved a rating of 4.5 out of 5 for the ncqa health plan ratings which were released in 2023. Tufts health public plans continues to implement outreach programs with both providers and members with the goal of improving the quality of care provided and received. Updated ratings for 2024 will be posted in september 2024. Tufts health public plans was the first plan in Massachusetts and among the first in new england to achieve ncqa health equity accreditation. ----------

Financial Efficiency

• Mission deployment rate: 100%; rating input score 100
• Program expense ratio: 96.8%; rating input score 97
• Fundraising efficiency: Limited

Transparency & Controls

• Consistency checks: 93.3%; rating input score 93; 21st percentile among comparable filings
• Pay-setting controls: 0 of 6 controls in place; rating input score 0
  • Compensation committee: Missing
  • Independent consultant: Missing
  • Other Form 990s reviewed: Missing
  • Written employment contract: Missing
  • Compensation survey or study: Missing
  • Board or committee approval: Missing
• Foreign activity oversight: Limited
• Grant itemization coverage: 100%; rating input score 100; 77th percentile among comparable filings
• Major donor itemization: Limited
• Related-party transparency: Yes; rating input score 100

Accountability

• Independent voting board: 100%; rating input score 100; 77th percentile among comparable filings
• Governance controls: 9 of 9 controls in place; rating input score 100
  • Conflict-of-interest policy: Pass
  • Whistleblower policy: Pass
  • Document-retention policy: Pass
  • CEO compensation review process: Pass
  • Other executive compensation review process: Pass
  • Form 990 shared with the board: Pass
  • Board meeting minutes documented: Pass
  • Audit committee oversight: Pass
  • Independent financial-statement audit: Pass

Sustainability

• Operating margin: -5%; rating input score 13; 13th percentile among comparable filings
• Total-asset coverage ratio: 0.37; rating input score 13; 13th percentile among comparable filings
• Liabilities to assets ratio: 0.7; rating input score 22; 22nd percentile among comparable filings
• Officer compensation ratio: 0%; rating input score 94; 94th percentile among comparable filings

Growth

• Program expense growth: 5.9% per year; rating input score 100; 49th percentile among comparable filings
• Revenue growth: 5.7% per year; rating input score 100; 49th percentile among comparable filings
• Asset growth: 9.1% per year; rating input score 100; 65th percentile among comparable filings