September 13, 2002

MGH discontinues Secure Horizons participation

The MGH has made the difficult decision to discontinue its participation in Secure Horizons, effective Jan. 1, 2003. Secure Horizons is the Medicare + Choice plan offered by Tufts Health Plan.

Approximately 3,500 seniors who currently receive their primary care from an MGH physician are enrolled in Secure Horizons. That means that these patients will need to make some significant decisions regarding their insurance coverage.

About half of these patients live in specific zip codes in which Tufts has decided to terminate all Secure Horizons coverage. These individuals will need to choose another insurance option. The remaining patients are being affected by the MGH's decision to discontinue participating in Secure Horizons. If these seniors wish to continue with their MGH physician, they will need to revert to traditional Medicare and can also purchase Medigap coverage. If they choose to remain in Secure Horizons, they will need to transfer their care to a non-MGH physician.

The MGH made this decision after months of discussion and evaluation of the various issues associated with Secure Horizons. In 2001, for example, the MGH lost more than $4 million by providing care to the patients covered by Secure Horizons, representing a loss of more than $1,000 per patient. The losses stem from the federal government's significant underfunding of Medicare HMOs.

" We understand and are very concerned about the difficulties and disruption associated with discontinuing Secure Horizons," says Nancy Gagliano, MD, vice president for MGH Physician Practice Management and Service Improvement. "We are making every effort to communicate with all patients affected, help them understand their options and ensure as smooth and comfortable a transition as possible. Our goal is to make sure that every patient continues to have access to high-quality medical care."

MGH primary care physicians have sent letters to all of their patients who are affected by the discontinuation of Secure Horizons. This letter explains the various options that patients have. A special help line has been set up for seniors to call and discuss their individual situations at (617) 724-1446.