Tufts Health Plan of New England doesn't have enough money to pay its claims after being placed in receivership late last year.
The liquidation of the Tufts New England operation--a subsidiary of Waltham, Mass.based Tufts Health Plan, which insures subscribers in Massachusetts--is an indicator of managed care woes throughout New England. Last month, the state of Massachusetts placed Harvard Pilgrim Health Care in receivership (see story on page 2).
Tufts Health Plan of New England had 145,000 subscribers in New Hampshire, Maine and Rhode Island. Tufts' Massachusetts plan has 975,000 enrollees.
The Tufts New England plan was placed in receivership Nov. 22, and in late December the New Hampshire Insurance Department ordered liquidation of its operations. Coverage for patients ends Feb. 2.
Claims will be paid for services rendered after Dec. 20, according to the New Hampshire Insurance Department. It's unknown how much of claims prior to Dec. 20 will be paid, says Monica Ciolfi, deputy commissioner for the Insurance Department.
Tufts Health Plan of New England had more than $100 million in losses, says Richard Hallworth, chief financial officer for Tufts Health Plan, the parent company.
There was no real hope of turning around the New England plan, he says. "Our financial net worth is below the levels of what we want it to be at, what we need it to be at," Hallworth says. Net worth as of Sept. 30 was $61 million but should have been about $90 million, he says.
The New Hampshire Insurance Department has worked with physicians, allowing them to "take a deep breath and do their work," says Georgia Tuttle, M.D., president of the New Hampshire Medical Society.
"If there are groups who have extraordinary debt which isn't paid, we'll have to deal with it when it comes up . . . That's something we're concerned about."