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Your Choice 3-Tier Option— a Tiered Provider Network Plan 2018 Hospital Tiering List

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Your Choice 3-Tier Option— a Tiered Provider Network Plan 2018 Hospital Tiering List Your Choice 3-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 or Tier 3, 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 2 Brockton Hospital 1 Androscoggin Valley Hospital 2 Cambridge Health Alliance 1 Anna Jaques Hospital 1 Cape Cod Hospital 2 Athol Memorial Hospital 1 Catholic Medical Center 2 Baystate Franklin Medical Center 1 Cheshire Medical Center 2 Baystate Medical Center 1 Clinton Hospital 1 Baystate Noble Hospital 1 Concord Hospital 2 Baystate Wing Memorial Hospital 1 Cooley Dickinson Hospital 2 Berkshire Medical Center 3 Cottage Hospital 2 Beth Israel Deaconess Medical Center - Boston 1 Dana-Farber Cancer Institute 3 Beth Israel Deaconess Medical Center - Milton 1 Elliot Hospital 2 Beth Israel Deaconess Medical Center - Needham 1 Emerson Hospital 3 Beth Israel Deaconess Medical Center - Plymouth 1 Exeter Hospital 2 Boston Children's Hospital 3 Fairview Hospital 3 Boston Medical Center 1 Falmouth Hospital 2 Brattleboro Memorial Hospital 2 Franklin Regional Hospital 2 Brigham and Women's Faulkner Hospital 3 Frisbie Memorial Hospital 2 Brigham and Women's Hospital 3 YC-HOSPITAL-TIERING-3T_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 2 Hospital) Hallmark Health Systems: Melrose Wakefield Hospital 1 Roger Williams Medical Center 2 Harrington Memorial Hospital 2 St. Joseph Hospital - Nashua 2 HealthAlliance Hospital 1 St. Joseph Hospital - Providence 2 Heywood Hospital 1 Saint Vincent Hospital 1 Holyoke Medical Center 1 Southcoast Hospitals Group: Charlton Memorial Huggins Hospital 2 1 Hospital Kent Hospital 2 Southcoast Hospitals Group: St. Luke's Hospital 1 Lahey Hospital and Medical Center 1 Southcoast Hospitals Group: Tobey Hospital 1 Lakes Region General Hospital 2 South County Hospital 2 Landmark Medical Center 2 South Shore Hospital 1 Lawrence General Hospital 1 Southern Maine Medical Center 2 Littleton Regional Hospital 2 Southern New Hampshire Medical Center 2 Lowell General Hospital 1 Southwestern Vermont Medical Center 2 Maine Medical Center 2 Speare Memorial Hospital 2 Marlborough Hospital 1 Steward Carney Hospital 1 Martha's Vineyard Hospital 3 Steward Good Samaritan Medical Center 1 Mary Hitchcock Memorial Hospital 2 Steward Holy Family at Merrimack Valley Hospital 1 Massachusetts Eye & Ear Infirmary 1 Steward Holy Family Hospital 1 Massachusetts General Hospital 3 Steward Morton Hospital and Medical Center 1 Memorial Hospital - NH 2 Steward Nashoba Valley Medical Center 1 Memorial Hospital of Rhode Island 2 Steward Norwood Hospital 1 Mercy Medical Center 3 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 2 The Miriam Hospital 2 Mt. Ascutney Hospital and Health Center 2 Tufts Medical Center 1 Mount Auburn Hospital 1 UMass Memorial Medical Center 1 Nantucket Cottage Hospital 3 Upper Connecticut Valley Hospital 2 New England Baptist Hospital 1 Valley Regional Hospital 2 New London Hospital 2 Westerly Hospital 2 Newport Hospital 2 Weeks Medical Center 2 Newton-Wellesley Hospital 3 Wentworth-Douglass Hospital 2 North Shore Medical Center 3 Winchester Hospital 1 Northeast Hospital Corp: Addison Gilbert Hospital 1 Women and Infants Hospital of Rhode Island 2 Northeast Hospital Corp: Beverly Hospital 1 York Hospital 2 Parkland Medical Center 2 Portsmouth Regional Hospital 2 YC-HOSPITAL-TIERING-3T_10/2017 Tier 1 HOSPITAL STATE HOSPITAL STATE Anna Jaques Hospital MA Metrowest Medical Center MA Athol Memorial Hospital MA Milford Regional Medical Center MA Baystate Franklin Medical Center MA Mount Auburn Hospital MA Baystate Medical Center MA New England Baptist Hospital MA Baystate Noble Hospital MA Northeast Hospital Corp: Addison Gilbert Hospital MA Baystate Wing Memorial Hospital MA Northeast Hospital Corp: Beverly Hospital MA Beth Israel Deaconess Medical Center - Boston MA Saint Vincent Hospital MA Beth Israel Deaconess Medical Center - Milton MA South Shore Hospital MA Beth Israel Deaconess Medical Center - Needham MA Southcoast Hospitals Group: Charlton Memorial MA Hospital Beth Israel Deaconess Medical Center - Plymouth MA Southcoast Hospitals Group: St. Luke's Hospital MA Boston Medical Center MA Southcoast Hospitals Group: Tobey Hospital MA Brockton Hospital MA Steward Carney Hospital MA Cambridge Health Alliance MA Steward Good Samaritan Medical Center MA Clinton Hospital MA Steward Holy Family at Merrimack Valley Hospital MA Hallmark Health Systems: Lawrence Memorial Hospital MA Steward Holy Family Hospital MA Hallmark Health Systems: Melrose Wakefield Hospital MA Steward Morton Hospital and Medical Center MA HealthAlliance Hospital MA Steward Nashoba Valley Medical Center MA Heywood Hospital MA Steward Norwood Hospital MA Holyoke Medical Center MA Steward St. Anne's Hospital MA Lahey Hospital and Medical Center MA Steward St. Elizabeth Medical Center MA Lawrence General Hospital MA Sturdy Memorial Hospital MA Lowell General Hospital MA Tufts Medical Center MA Marlborough Hospital MA UMass Memorial Medical Center MA Massachusetts Eye & Ear Infirmary MA Winchester Hospital MA YC-HOSPITAL-TIERING-3T_10/2017 Tier 2 HOSPITAL STATE HOSPITAL STATE Alice Peck Day Memorial Hospital NH Monadnock Community Hospital NH Androscoggin Valley Hospital NH Mt. Ascutney Hospital and Health Center VT Brattleboro Memorial Hospital VT New London Hospital NH Cape Cod Hospital MA Newport Hospital RI Catholic Medical Center NH Parkland Medical Center NH Cheshire Medical Center NH Portsmouth Regional Hospital NH Concord Hospital NH Rhode Island Hospital (including Hasbro Children's RI Hospital) Cooley Dickinson Hospital MA Roger Williams Medical Center RI Cottage Hospital NH St. Joseph Hospital - Nashua NH Elliot Hospital NH St. Joseph Hospital - Providence RI Exeter Hospital NH South County Hospital RI Falmouth Hospital MA Southern Maine Medical Center ME Franklin Regional Hospital NH Southern New Hampshire Medical Center NH Frisbie Memorial Hospital NH Southwestern Vermont Medical Center VT Harrington Memorial Hospital MA Speare Memorial Hospital NH Huggins Hospital NH The Miriam Hospital RI Kent Hospital RI Upper Connecticut Valley Hospital NH Lakes Region General Hospital NH Valley Regional Hospital NH Landmark Medical Center RI Westerly Hospital RI Littleton Regional Hospital NH Weeks Medical Center NH Maine Medical Center ME Wentworth-Douglass Hospital NH Mary Hitchcock Memorial Hospital NH Women and Infants Hospital of Rhode Island RI Memorial Hospital - NH NH York Hospital ME Memorial Hospital of Rhode Island RI Tier 3 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-3T_10/2017.
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