Harvard Pilgrim Health Care and Boston Childrens Hospital Agree on Contract

Keeps Cost Increases Below Inflation and Focuses on Improving Quality

March 25, 2013

Wellesley/Boston, MA – Harvard Pilgrim Health Care and Boston Children’s Hospital announced today that they have reached an agreement that limits cost increases to below inflation, improves access for patients to get care at Boston Children’s lower-cost outpatient satellites in Peabody, Waltham and Lexington and continues to improve quality based on pediatric quality metrics.

“We worked closely with Boston Children’s Hospital on an innovative arrangement that will provide quality and value to consumers and employers and at the same time acknowledges the complexity of care required by a substantial portion of Boston Children’s patients,“ said Eric Schultz, Harvard Pilgrim president and CEO.  “We want to support Boston Children’s care of patients in the most appropriate setting for the patient’s needs – whether at home, in the community, or at the hospital itself. This is a win-win agreement for patients, employers and Boston Children’s.”  

In addition to limiting health insurance rate increases below inflation, the contract supports innovative new ways to deliver care, including a continued focus on medical homes, programs that move services from inpatient settings to less costly outpatient locations, and telehealth services. In addition, Harvard Pilgrim and Boston Children’s are working together to develop bundled pricing for more routine services.

“We appreciate Harvard Pilgrim’s willingness to engage with us as we work to slow the growth of health care costs and deliver high-quality care in more efficient ways to benefit patients and families,” said Sandra Fenwick, Boston Children’s President and COO. “The contract strengthens our Community of Care by further investing in our efforts to improve care coordination with primary care physicians through medical homes and by supporting family-centered innovations in care ranging from home visiting to day treatment for conditions previously treated in the inpatient setting. Patients and families will benefit through lower costs and greater convenience to our high quality care."

Mary Wallan
(617) 509-2419

Rob Graham
(617) 919-3111

About Harvard Pilgrim Health Care

Harvard Pilgrim Health Care is a not-for-profit health plan serving more than one million members in New England.  Founded in 1969, the health plan has built its reputation on pragmatic innovation with a goal of lowering costs, improving care and enhancing the overall member experience.  Harvard Pilgrim is known for its excellent clinical programs, customer service, health improvement strategies and innovative tools that offer consumers greater transparency and empower them to make better decisions about their health care.

Harvard Pilgrim is the #1 private health plan in America again according to an annual ranking of the nation’s best health plans by the National Committee for Quality Assurance (NCQA). Harvard Pilgrim is the only private health plan in the nation to be named #1 for member satisfaction and quality of care for nine consecutive years.*

* NCQA’s Private Health Insurance Plan Rankings, 2011-13, HMO/POS. NCQA’s Health Insurance Plan Rankings 2010-11 – Private.U.S. News/NCQA America’s Best Health Insurance Plans 2005-2009 (annual). America’s Best Health Insurance Plans is a trademark of U.S.News & World Report. NCQA The State of Health Care Quality 2004. Harvard Pilgrim Health Care of New England, Harvard Pilgrim’s New Hampshire affiliate, is the top-ranked plan in New Hampshire and the seventh highest-ranked private health plan in America.

About Boston Children’s Hospital

Boston Children’s Hospital is home to the world’s largest research enterprise based at a pediatric medical center, where its discoveries have benefited both children and adults since 1869. More than 1,100 scientists, including nine members of the National Academy of Sciences, 11 members of the Institute of Medicine and 11 members of the Howard Hughes Medical Institute comprise Boston Children’s research community. Founded as a 20-bed hospital for children, Boston Children’s today is a 395-bed comprehensive center for pediatric and adolescent health care grounded in the values of excellence in patient care and sensitivity to the complex needs and diversity of children and families. Boston Children’s also is a teaching affiliate of Harvard Medical School. For more information about research and clinical innovation at Boston Children’s, visit: http://vectorblog.org/.