posted by Alicia Caramenico
on January 26, 2017
Tufts Health Plan, a not-for-profit organization based in Massachusetts, was founded in 1979 by a physician at Tufts University Medical School. Today, it serves more than a million members in the commercial, Medicare, Medicaid and exchange markets in Massachusetts, New Hampshire and Rhode Island. AHIP recently spoke with Tom Croswell, Tufts President and CEO, and also one of our new board members. Read on to learn more about Tufts Health Plan’s commitment to quality, diversity, and engaged employees.
You joined Tufts Health Plan in 2007 as chief operating officer and now serve as the CEO. What was your career journey like?
Croswell: I first got into this field right out of college in ‘70s. I worked for Prudential for about 25 years, wearing a variety of different hats and in different states. I then spent nine years with Cigna in a variety of ways, including leading its dental and pharmacy business. I joined Tufts Health Plan back in 2007. I went to high school in Massachusetts, so this was a return home for me.
How did you make the decision to become involved as a member of the AHIP Board?
Croswell: I have been involved with AHIP for many years in various ways. At Tufts Health Plan we’re interested in belonging to AHIP and the work it does because it’s involved in future of health care, and that’s obviously important to us.
We value engagement at every level of the AHIP organization, so it’s not just me serving on the board. This involvement is a good connection for health care policy and its impact on the industry and a way to share best practices and learnings across other health plans nationally.
Where do you see health care heading in the future?
Croswell: Near-term, Tufts Health Plan is focused on affordability and stability in the marketplaces we serve. As a health plan, it’s our role to keep products accessible and affordable for our members and employer partners. Health plans can continue to provide considerable value by pioneering value-based payment models across all product lines and programs – an area where we have a long and strong history. We can also work with our provider partners to offer tools and services that promote health and well-being.
Tell us about some new initiatives you’re leading at Tufts Health Plan right now.
Croswell: Our mission is to improve the health and wellness of the diverse communities we serve. A perfect example is our involvement in the dual eligible [Medicare and Medicaid] program for the under 65 and over 65 populations – very fragile populations. That’s really an area where we think we can fulfill our mission.
Another example is diversity and inclusion. We know health disparities do exist and there’s an opportunity to improve care for ethnically diverse communities, LGBTQ members, and people with disabilities. This is not just the right thing to do, it is also good business. We’re better serving the increasingly diverse communities that are our customer base.
We have also developed special programs to provide additional support to members who need help. For example, we worked with the local chapter of the Alzheimer’s Association to develop a program to help individuals suffering with Alzheimer’s and their family members cope with the disease, understand the impact it will have, and obtain support from community resources and care managers from Tufts Health Plan. The model is so successful it’s being replicated in other parts of the country.
How is your organization building on its commitment to improving health care quality and safety?
Croswell: Our continuing commitment to improving health care quality and safety is reflected by our consistently high quality ratings. We are one of the few 5-star Medicare Advantage plans in the country. We also have a 5 rating for our commercial business and a 4.5 rating for our Medicaid programs from NCQA – all top-of-the-charts rankings were very proud of. Helping with the needs of an increasingly diverse population and social determents of health is also part of this commitment.
Anything else you would like to share about yourself or your organization?
Croswell: The employees in our organization are extraordinary. They believe very strongly in our mission and demonstrate their commitment to improving the lives of our members each and every day.
A third of our employees volunteer their time at local nonprofits throughout the year and take advantage of Tufts Health Plan Foundation matching employee donations. To date, Tufts Health Plan has contributed more than $25 million to local communities through the Tufts Health Plan Foundation and corporate giving. Our diverse, committed workforce goes above and beyond to serve our members.
This interview has been condensed and edited for length and clarity.