Narrow Networks - Part II

By CHARLIE BAKER

For the past six years, Harvard Pilgrim has offered a limited network product to our New Hampshire members called “New Hampshire NetOption.” Simply put, all New Hampshire providers are Tier One providers - lowest co-pays - and so are all Massachusetts community hospitals. Tier Two providers are MA-based teaching hospitals (members have a higher co-pay for services there). That’s it. Two tiers - one for NH hospitals and MA community hospitals, and a different one for MA-based teaching hospitals.

There is, however, one catch. All NH hospitals and their physicians and all MA hospitals and their physicians are “in network” for this product - except Partners. When we set the product up, Partners chose not to participate because the plan design treated teaching hospitals differently than it treated community hospitals. That’s their call. NBD, as my kids would say.