TUFTS HEALTH PUBLIC PLANS INC

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Financial Vulnerability Assessment (Tuckman-Chang)

4 risk indicators measuring financial stability and operational resilience

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Financial Trends

Organization Details

Formation Year

2014

Legal Domicile

Principal Officer

SCOTT WALKER

Phone

6179729400

Tax Period

2023-01-01 to 2023-12-31

TUFTS HEALTH PUBLIC PLANS INC, founded in 2014, is a large national nonprofit in the Mutual Benefit sector that reported $2.5B in total revenue in fiscal year 2023. Revenue decreased 14% compared to the prior year.

Mission

DETAIL REGARDING THE ORGANIZATION'S MISSION TUFTS HEALTH PUBLIC PLANS, INC. ("THPP") IS A NONPROFIT CORPORATION WHOSE PURPOSE IS TO GUIDE AND EMPOWER HEALTHIER LIVES FOR EVERYONE. THPP SEEKS TO IMPROVE THE HEALTH AND WELLNESS OF THE DIVERSE COMMUNITIES IT SERVES BY ARRANGING FOR THE PROVISION OF COMPREHENSIVE HEALTH CARE SERVICES, INCLUDING PROVIDING COMMUNITY OUTREACH AND EDUCATION TO THE COMMUNITY IT SERVES. THE ORGANIZATION AIMS TO IMPROVE THE LIVES OF MASSACHUSETTS AND RHODE ISLAND RESIDENTS BY PROVIDING ACCESS TO HIGH-QUALITY, AFFORDABLE HEALTH CARE, PRIMARILY THROUGH MANAGED CARE PROGRAMS DIRECTED AT LOW TO MODERATE INCOME RESIDENTS OF THE COMMONWEALTH OF MASSACHUSETTS AND STATE OF RHODE ISLAND. THPP IS PART OF THE POINT32HEALTH ("P32H") FAMILY OF COMPANIES. ----------

Program Service Accomplishments

Program 1

Expenses: $1,288,168,951 Revenue: $1,310,496,498

TUFTS HEALTH TOGETHER IS THE NAME OF THPP'S MASSACHUSETTS MEDICAID MCO AND ACO PLANS THAT PROVIDE ACCESS TO AFFORDABLE HEALTH CARE FOR QUALIFIED RESIDENTS AND THEIR FAMILIES WHO MEET INCOME AND OTHER ELIGIBILITY REQUIREMENTS. MASSHEALTH IS THE NAME OF THE MASSACHUSETTS MEDICAID PROGRAM FUNDED BY THE FEDERAL GOVERNMENT AND THE STATE. MASSHEALTH HELPS PEOPLE WITH LIMITED INCOMES AND RESOURCES PAY FOR MEDICAL AND SUPPORT SERVICES. (See Schedule O)

Program 2

Expenses: $774,747,746 Revenue: $788,176,277

TUFTS HEALTH DIRECT IS AN INDIVDUAL AND SMALL GROUP QUALIFIED HEALTH PLAN ("QHP") ESTABLISHED BY THE ORGANIZATION AFTER THE ENACTMENT OF THE AFFORDABLE CARE ACT TO PROVIDE ACCESS TO AFFORABLE HEALTH CARE FOR INDIVIDUALS AND FAMILIES WHO ARE NOT ELIGIBLE FOR AFFORDABLE EMPLOYER-SPONSORED INSURANCE, AND SMALL EMPLOYER GROUPS WITH 1-50 EMPLOYEES. (SEE SCHEDULE O)

Program 3

Expenses: $234,593,664 Revenue: $238,659,824

TUFTS HEALTH UNIFY IS A MEDICARE-MEDICAID PLAN FOR INDIVIDUALS AGE 21-64 WHO ARE ELIGIBLE FOR BOTH MEDICARE AND MEDICAID. TUFTS HEALTH UNIFY IS ONE OF THREE MASSACHUSETTS ONECARE PLANS PARTICIPATING IN THE FINANCIAL ALIGNMENT INITIATIVE ('DUALS DEMONSTRATION') TO INTEGRATE BENEFITS AND CARE FOR MEDICARE-MEDICAID ENROLLEES. THE PLAN CONTRACTS WITH THE CENTER FOR MEDICARE AND MEDICAID SERVICES AND E MASSACHUSETTS EXECUTIVE OFFICE OF HEALTH AND HUMAN SERVICES TO PROVIDE THE BENEFITS OF BOTH PROGRAMS TO LOW AND MODERATE INCOME INDIVIDUALS WITH DISABILITIES. (SEE SCHEDULE O)

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Trantor Score

Financial Health Score (300–850) · Liquidity · Solvency · Sustainability · Efficiency

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Liquidity (40%) • Solvency (30%) • Sustainability (20%) • Efficiency (10%)

Financial Overview (2023)

Revenue Breakdown

Contributions & Grants $0

Program Service Revenue $2,436,844,851

Investment Income $34,050,973

Other Revenue $0

TOTAL REVENUE $2,470,895,824

Expense Breakdown

Grants Paid $534,938

Salaries & Benefits $38,049,188

Fundraising Expenses $0

Program Expenses $2,395,327,176

Other Expenses $234,698,428

TOTAL EXPENSES $2,479,848,703

Year-over-Year Comparison

	2023	2022	Change
Revenue	$2,470,895,824	$2,887,097,853	-0.1%
Expenses	$2,479,848,703	$2,846,959,022	-0.1%
Net Income	$-8,952,879	$40,138,831	-1.2%

Key Indicators

✓ Grants to Organizations ✗ Grants to Individuals ✗ Lobbying ✗ Political Activity ✗ Foreign Activities ✗ Donor Advised Fund ✗ Schedule B Required

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Financial Health Indicators

Comprehensive financial analysis: Altman Z-Score, liquidity, solvency, sustainability, efficiency, and growth metrics

Financial Distress Indicator

Liquidity & Cash Position

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Altman Z-Score • Liquidity Ratios • Solvency Analysis • Growth Indicators • Efficiency Metrics

Governance

Voting Members

Independent Members

Employees

565

Volunteers

N/A

Governance Policies

✗ Conflict of Interest Policy

✗ Whistleblower Policy

✗ Document Retention Policy

Special Practices & Reported Activities

✗ Operated a School

✗ Operated a Hospital

✗ Provided First Class Travel

⚠ Reported Conflict of Interest

✗ Reported Asset Diversion

✗ Excess Benefit Transaction

✗ Made Political Expenditures

✗ Engaged in Lobbying

✗ Operated Donor Advised Fund

✗ Maintained Art Collections

✗ Filed Form 720

Compensation of Officers, Directors & Key Employees

Total Officers

$10,969,455

Total Directors

$5,710,334

Key Employees

$3,624,892

Highest Compensated

reported

Name	Title	Hours/Week	Role	Reportable Comp	Other Comp	Total
CAIN HAYES	PRESIDENT & CEO	10.0	Officer Director	$0	$387,442	$4,246,459
PHILIP BARR	EVP, PRESIDENT, MARKETS	10.0	Key Emp	$0	$201,705	$1,952,558
PATRICIA HOWARD	COO (END 5/3)	12.5	Key Emp	$0	$59,229	$1,672,334
UMESH KURPAD	CFO (END 7/4)	10.0	Officer	$0	$166,409	$1,621,244
PETE CHURCH	CHIEF PEOPLE OFFICER	10.0	Highest	$0	$199,722	$1,548,068
TISA HUGHES	CLERK/SECRETARY	10.0	Officer	$0	$135,726	$1,466,203
TRACEY CARTER	SVP, CHIEF ACTUARY	12.5	Highest	$0	$167,611	$1,343,146
SELMA FERHATBEGOVIC	SVP, CHIEF INFORMATION OFFICER	10.0	Highest	$0	$152,803	$1,260,256
MARK PORTER	TREASURER (START 10/12)	10.0	Officer	$0	$166,825	$1,222,453
KRISTIN LEWIS	CHIEF PUB & COMN AFF OFFICER	10.0	Highest	$0	$152,533	$1,187,178
DEAN PEASLEY	SVP, OPERATIONS	12.5	Highest	$0	$138,389	$973,219
MICHAEL CARSON	FORMER PRESIDENT (END 10/1/21)	0.0		$0	$0	$866,154
R SCOTT WALKER	CFO (START 7/5)	10.0	Officer	$0	$117,945	$845,896
SUSAN KEE	CLERK/SECRETARY (START 12/11)	10.0	Officer	$0	$72,203	$717,571
ROLAND PRICE	TREASURER (END 10/11)	10.0	Officer	$0	$79,256	$675,379
THOMAS CROSWELL	FORMER CEO	0.0		$0	$9,150	$621,650
EILEEN AUEN	DIRRCTOR, CHAIR	2.0	Officer Director	$0	$0	$161,250
MICHAEL J MCCOLGAN	DIRECTOR	1.0	Director	$0	$0	$131,750
GREGORY D TRANTER	DIRECTOR	1.0	Director	$0	$0	$129,375
MICHAEL SHEA	DIRECTOR	1.0	Director	$0	$0	$123,375
BERTRAM L SCOTT	DIRECTOR	1.0	Director	$0	$0	$119,375
HEDWIG VEITH WHITNEY	DIRECTOR	1.0	Director	$0	$0	$117,375
MYECHIA MINTER-JORDAN MD	DIRECTOR (END 12/8)	1.0	Director	$0	$0	$116,375
TODD WHITBECK	DIRECTOR	1.0	Director	$0	$0	$113,000
PETER SLAVIN MD	DIRECTOR	1.0	Director	$0	$0	$112,000
RAYMOND PAWLICKI	DIRECTOR	1.0	Director	$0	$0	$111,000
IRINA SIMMONS	DIRECTOR	1.0	Director	$0	$0	$109,000
JOYCE MURPHY	DIRECTOR	1.0	Director	$0	$0	$107,000
GREG SHELL	DIRECTOR, VICE CHAIR	1.0	Officer Director	$0	$0	$13,000

Note: Compensation data is self-reported by the organization on their Form 990. "Reportable Comp" includes salary, bonuses, and other reportable compensation from the organization and related organizations. "Other Comp" includes benefits, deferred compensation, and non-taxable benefits.

Historical Data

Year	Revenue	Expenses	Assets	Net Income
2024	No data	No data	No data	No data
2023	$2,470,895,824	$2,479,848,703	$1,156,361,918	$-8,952,879
2022	$2,887,097,853	$2,846,959,022	$1,077,858,471	$40,138,831
2021	$2,728,584,745	$2,775,239,488	$1,008,368,320	$-46,654,743
2020	$2,527,590,380	$2,589,912,930	$881,482,929	$-62,322,550
2019	$2,212,357,802	$2,204,794,907	$767,664,311	$7,562,895
2018	$2,180,534,846	$2,126,571,157	$653,961,790	$53,963,689