Your Choice 2-Tier Option— A Tiered Provider Network Plan 2018 Hospital Tiering List
Your Choice is a Tufts Health Plan tiered provider network comprised of primary care providers, specialists and hospitals. As part of our National Committee for Quality Assurance (NCQA) accreditation and our own quality standards, we are committed to contracting only with high-performing hospitals. Every doctor and every hospital in the Your Choice network has been carefully evaluated, and every provider and hospital in the Your Choice network meets our standard for quality of care. Because not all doctors and hospitals charge the same costs, we’ve factored in cost-efficiency in our evaluation, and we have separated Your Choice providers into three tiers. Provider groups and their primary hospital affiliation are in the same tier to reflect referral patterns that those physicians would make most often.* Below is a list of all the hospitals in Tufts Health Plan’s network and their tiers. In choosing a tier, members must consider how much they are willing to pay out-of-pocket for the doctor and/ or hospital they prefer. If members want the most cost-effective option, they should choose a doctor or hospital from Tier 1. If the doctor or hospital is in Tier 2, they have the freedom to choose, but they will pay higher out-of- pocket costs. Members pay different levels of copayments, coinsurance, and/or deductibles depending on their plan design and the tier of the provider delivering a covered service or supply. Your plan may make changes to a provider’s tier annually. Please consult the Your Choice provider directory or visit the provider search tool at tuftshealthplan.com and click on Find a Doctor to determine the tier of providers in the Your Choice Tiered Provider Network.
*We have created the provider tiers for Your Choice at the physician group level—not on an individual provider basis. A physician’s tier does not guarantee the quality of care that members might receive from a specific physician or practice group, or a certain health outcome. Members should always speak with their physician when making decisions about where to get care.
Complete Hospital Tiering List
HOSPITAL TIER HOSPITAL TIER Alice Peck Day Memorial Hospital 1 Brockton Hospital 1 Androscoggin Valley Hospital 1 Cambridge Health Alliance 1 Anna Jaques Hospital 1 Cape Cod Hospital 1 Athol Memorial Hospital 1 Catholic Medical Center 1 Baystate Franklin Medical Center 1 Cheshire Medical Center 1 Baystate Medical Center 1 Clinton Hospital 1 Baystate Noble Hospital 1 Concord Hospital 1 Baystate Wing Memorial Hospital 1 Cooley Dickinson Hospital 1 Berkshire Medical Center 2 Cottage Hospital 1 Beth Israel Deaconess Medical Center - Boston 1 Dana-Farber Cancer Institute 2 Beth Israel Deaconess Medical Center - Milton 1 Elliot Hospital 1 Beth Israel Deaconess Medical Center - Needham 1 Emerson Hospital 2 Beth Israel Deaconess Medical Center - Plymouth 1 Exeter Hospital 1 Boston Children's Hospital 2 Fairview Hospital 2 Boston Medical Center 1 Falmouth Hospital 1 Brattleboro Memorial Hospital 1 Franklin Regional Hospital 1 Brigham and Women's Faulkner Hospital 2 Frisbie Memorial Hospital 1 Brigham and Women's Hospital 2
YC-HOSPITAL-TIERING-2T_10/2017 Complete Hospital Tiering List (cont.)
HOSPITAL TIER HOSPITAL TIER
Hallmark Health Systems: Lawrence Memorial Hospital 1 Rhode Island Hospital (including Hasbro Children's 1 Hospital) Hallmark Health Systems: Melrose Wakefield Hospital 1 Roger Williams Medical Center 1 Harrington Memorial Hospital 1 Saint Vincent Hospital 1 HealthAlliance Hospital 1 South County Hospital 1 Heywood Hospital 1 South Shore Hospital 1 Holyoke Medical Center 1 Southcoast Hospitals Group: Charlton Memorial Huggins Hospital 1 1 Hospital Kent Hospital 1 Southcoast Hospitals Group: St. Luke's Hospital 1 Lahey Hospital and Medical Center 1 Southcoast Hospitals Group: Tobey Hospital 1 Lakes Region General Hospital 1 Southern Maine Medical Center 1 Landmark Medical Center 1 Southern New Hampshire Medical Center 1 Lawrence General Hospital 1 Southwestern Vermont Medical Center 1 Littleton Regional Hospital 1 Speare Memorial Hospital 1 Lowell General Hospital 1 St. Joseph Hospital - Nashua 1 Maine Medical Center 1 St. Joseph Hospital - Providence 1 Marlborough Hospital 1 Steward Carney Hospital 1 Martha's Vineyard Hospital 2 Steward Good Samaritan Medical Center 1 Mary Hitchcock Memorial Hospital 1 Steward Holy Family at Merrimack Valley Hospital 1 Massachusetts Eye & Ear Infirmary 1 Steward Holy Family Hospital 1 Massachusetts General Hospital 2 Steward Morton Hospital and Medical Center 1 Memorial Hospital - NH 1 Steward Nashoba Valley Medical Center 1 Memorial Hospital of Rhode Island 1 Steward Norwood Hospital 1 Mercy Medical Center 2 Steward St. Anne's Hospital 1 Metrowest Medical Center 1 Steward St. Elizabeth Medical Center 1 Milford Regional Medical Center 1 Sturdy Memorial Hospital 1 Monadnock Community Hospital 1 The Miriam Hospital 1 Mount Auburn Hospital 1 Tufts Medical Center 1 Mt. Ascutney Hospital and Health Center 1 UMass Memorial Medical Center 1 Nantucket Cottage Hospital 2 Upper Connecticut Valley Hospital 1 New England Baptist Hospital 1 Valley Regional Hospital 1 New London Hospital 1 Weeks Medical Center 1 Newport Hospital 1 Wentworth-Douglass Hospital 1 Newton-Wellesley Hospital 2 Westerly Hospital 1 North Shore Medical Center 2 Winchester Hospital 1 Northeast Hospital Corp: Addison Gilbert Hospital 1 Women and Infants Hospital of Rhode Island 1 Northeast Hospital Corp: Beverly Hospital 1 York Hospital 1 Parkland Medical Center 1 Portsmouth Regional Hospital 1
YC-HOSPITAL-TIERING-2T_10/2017 Tier 1
HOSPITAL STATE HOSPITAL STATE
Alice Peck Day Memorial Hospital NH Kent Hospital RI Androscoggin Valley Hospital NH Lahey Hospital and Medical Center MA Anna Jaques Hospital MA Lakes Region General Hospital NH Athol Memorial Hospital MA Landmark Medical Center RI Baystate Franklin Medical Center MA Lawrence General Hospital MA Baystate Medical Center MA Littleton Regional Hospital NH Baystate Noble Hospital MA Lowell General Hospital MA Baystate Wing Memorial Hospital MA Maine Medical Center ME Beth Israel Deaconess Medical Center - Boston MA Marlborough Hospital MA Beth Israel Deaconess Medical Center - Milton MA Mary Hitchcock Memorial Hospital NH Beth Israel Deaconess Medical Center - Needhan MA Massachusetts Eye & Ear Infirmary MA Beth Israel Deaconess Medical Center - Plymouth Ma Memorial Hospital - NH NH Boston Medical Center MA Memorial Hospital of Rhode Island RI Brattleboro Memorial Hospital VT Metrowest Medical Center MA Brockton Hospital MA Milford Regional Medical Center MA Cambridge Health Alliance MA Monadnock Community Hospital NH Cape Cod Hospital MA Mount Auburn Hospital MA Catholic Medical Center NH Mt. Ascutney Hospital and Health Center VT Cheshire Medical Center NH New England Baptist Hospital MA Clinton Hospital MA New London Hospital NH Concord Hospital NH Newport Hospital RI Cooley Dickinson Hospital MA Northeast Hospital Corp: Addison Gilbert Hospital MA Cottage Hospital NH Northeast Hospital Corp: Beverly Hospital MA Elliot Hospital NH Parkland Medical Center NH Exeter Hospital NH Portsmouth Regional Hospital NH Rhode Island Hospital (including Hasbro Children's Falmouth Hospital MA RI Hospital) Franklin Regional Hospital NH Roger Williams Medical Center RI Frisbie Memorial Hospital NH Saint Vincent Hospital MA Hallmark Health Systems: Lawrence Memorial Hospital MA South County Hospital RI Hallmark Health Systems: Melrose Wakefield Hospital MA South Shore Hospital MA Harrington Memorial Hospital MA Southcoast Hospitals Group: Charlton Memorial MA HealthAlliance Hospital MA Hospital Heywood Hospital MA Southcoast Hospitals Group: St. Luke's Hospital MA Holyoke Medical Center MA Southcoast Hospitals Group: Tobey Hospital MA Huggins Hospital NH Southern Maine Medical Center ME
YC-HOSPITAL-TIERING-2T_10/2017 Tier 1 (cont.)
HOSPITAL STATE HOSPITAL STATE Southern New Hampshire Medical Center NH Steward St. Elizabeth Medical Center MA Southwestern Vermont Medical Center VT Sturdy Memorial Hospital MA Speare Memorial Hospital NH The Miriam Hospital RI St. Joseph Hospital - Nashua NH Tufts Medical Center MA St. Joseph Hospital - Providence RI UMass Memorial Medical Center MA Steward Carney Hospital MA Upper Connecticut Valley Hospital NH Steward Good Samaritan Medical Center MA Valley Regional Hospital NH Steward Holy Family at Merrimack Valley Hospital MA Weeks Medical Center NH Steward Holy Family Hospital MA Wentworth-Douglass Hospital NH Steward Morton Hospital and Medical Center MA Westerly Hospital RI Steward Nashoba Valley Medical Center MA Winchester Hospital MA Steward Norwood Hospital MA Women and Infants Hospital of Rhode Island RI Steward St. Anne's Hospital MA York Hospital ME
Tier 2
HOSPITAL STATE
Berkshire Medical Center MA Boston Children's Hospital MA Brigham and Women's Faulkner Hospital MA Brigham and Women's Hospital MA Dana-Farber Cancer Institute MA Emerson Hospital MA Fairview Hospital MA Martha's Vineyard Hospital MA Massachusetts General Hospital MA Mercy Medical Center MA Nantucket Cottage Hospital MA Newton-Wellesley Hospital MA North Shore Medical Center MA
YC-HOSPITAL-TIERING-2T_10/2017