11th hour deal: Point32Health and Tenet reach insurance coverage agreement

In an 11th-hour deal, Point32Health and Tenet Healthcare Corp. reached a four-year contract agreement to continue in-network coverage for members at Saint Vincent Hospital in Worcester and MetroWest Medical Center in Framingham and Natick.

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Point32Health, the state’s second-largest insurer and owner of Tufts Health and Harvard Pilgrim Health, informed MassLive of the agreement Monday evening, just 30 or so hours before 17,000 members were going to lose in-network benefits at the major Central Massachusetts hospitals as of Jan. 1.

UMass Memorial Health and Boston Children’s Hospital had already announced they could not reach a new contract by Jan. 1 with Point32Health for Tufts Health Direct members specifically. Between the two health systems, approximately 30,000 patients are affected — forced to find new providers or new insurance or pay out-of-pocket costs.

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Until Monday night, negotiations between Point32Health and for-profit Tenet were still ongoing.

“Point32Health has successfully reached a four-year contract agreement for all product lines with Tenet Healthcare for MetroWest Medical Center in Framingham and Natick, Saint Vincent Hospital in Worcester and Worcester Surgical Center in Worcester,” a spokesperson said in a statement to MassLive.

Details of the agreement were not released Monday.

The testy negotiations lasted many months, all while Point32Health and Tenet traded barbs in public messaging and the media.

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Dallas-based Tenet claimed Point32Health was “not engaging in good faith discussions to reach an equitable agreement,” and instead prioritizing profits over member access.

The hospital owner pointed to the insurer’s proposed $165 million purchase of a Western, Massachusetts-based health plan, while simultaneously reporting an operating loss in the first six months of 2024.

Meanwhile, Point32Health said Tenet had “demanded” reimbursement payments over the next four years significantly above the state Health Policy Commission’s cost growth benchmark.

The insurer accused Tenet of publishing “inaccurate messaging about our negotiations.”

Monday’s deal means Point32Health members will continue to receive uninterrupted care at Saint Vincent Hospital and MetroWest Medical Center at in-network status.