Massachusetts Medical Society: Summary of Health Plan Alignment with MMS Principles

Summary of Health Plan Alignment with MMS Principles

 

 Plan

Met

PartiallyMet

NotMet

 BCBSMA

8

14

7

 CIGNA

4

13

12

 Fallon

6

16

7

 Harvard Pilgrim

3

17

9

 Health NE

1

17

11

 Neighborhood

2

13

14

 Tufts

5

16

8

 Unicare

2

15

12

 

Pay for Performance

 Plan

Met

PartiallyMet

NotMet

N/A

 BCBSMA

13

3

0

0

 Fallon

12

2

2

0

 Harvard Pilgrim

5

2

5

4

 Health NE

4

2

2

8

 Neighborhood

3

3

2

8

 Tufts

3

11

2

0

 

Prior Authorization - Radiology

 Plan

Met

PartiallyMet

NotMet

N/A

  Aetna

13

3

9

0

  BCBSMA

18

1

6

0

  CIGNA

14

5

6

0

  Fallon

13

5

7

0

  Harvard Pilgrim

12

4

2

7

  Health NE

14

8

3

0

  Neighborhood

9

4

5

7

  Tufts

14

4

7

0

  United Healthcare

12

0

6

7

 

Prior Authorization - Antifungals

 Plan

Met

PartiallyMet

NotMet

N/A

  Aetna

14

2

8

1

  BCBSMA

12

3

9

1

 CIGNA

9

6

9

1

  Fallon

12

3

9

1

  Harvard Pilgrim

12

3

9

1

  Health NE*

10

5

8

2

  Neighborhood

10

4

10

1

  Tufts

13

2

9

1

  United Healthcare

9

5

9

2

* N/A for antifungals, for which Health NE does not require prior authorization. Chart measures HNE's alignment of prior authorization programs for other drugs.

 

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