An impending merger of two Massachusetts-based HMO networks would create an organization of 1 million enrollees throughout New England.
The combination of Brookline-based Harvard Community Health Plan and Norwell-based Pilgrim Health Care also would knit together pockets of enrollment concentration in metropolitan Boston, completing a blanket of geographic coverage in the competitive Boston managed-care market.
Last week the two not-for-profit companies announced their intention to create a single new organization based on equal partnership. Pending regulatory approvals and final reviews, the partners will elect an equal number of members to a new board of directors, a Harvard Community spokeswoman said. The new organization will be named later, she said.
The merger proposal with Pilgrim continues a recent flourish of expansion by Harvard Community in New England. In June alone, the HMO:
Agreed to merge with Matthew Thornton Health Plan, a Nashua, N.H.-based HMO with 105,000 enrollees in New Hampshire and Vermont.
Announced an affiliation with Martin's Point Health Care Centers, Maine's largest primary-care group practice. Its 25 physicians serve 35,000 patients at five sites.
Solidified a presence in western Massachusetts by affiliating with Berkshire Physicians and Surgeons, a 60-physician practice in Berkshire County.
Last May, Harvard Community began a joint venture with the Lahey Clinic, a Burlington, Mass.-based physician group practice, to develop a network of owned and managed primary-care practices in northern Massachusetts.
Harvard Community's working relationship with Lahey, another expansion-minded organization in New England, began in September 1993 with an affiliation that made Lahey's 315 physicians and 200-bed hospital part of Harvard Community's provider network (Sept. 20, 1993, p. 26).
Lahey also is working on an affiliation with the biggest multispecialty group practice in New Hampshire, 475-physician Hitchcock Clinic, owner of the Matthew Thornton Health Plan that's about to become part of Harvard Community.
Pilgrim Health Care, an independent-practice association of more than 11,000 physicians, has 330,000 enrollees in an HMO, a PPO and an arrangement that allows choice of network or non-network providers at the time enrollees seek care. It's strong on the south shore of metropolitan Boston and into Rhode Island, a spokeswoman said.
Harvard Community's 565,000 enrollees are concentrated in Boston, northern Massachusetts, southern New Hampshire and Rhode Island.
Under the agreement signed last week, Harvard Community's president and chief executive officer, Manuel Ferris, will assume that same position with the new organization. Allan Greenberg, Pilgrim's CEO, will become executive vice president and chief operating officer.
The union of Harvard Community, Pilgrim and Matthew Thornton would surpass Blue Cross and Blue Shield of Massachusetts as the largest HMO network in New England. Current enrollment in the Blues' two HMOs and a point-of-service plan exceeds 650,000, a spokesman said.