Point32Health
Also known as Point32, Point32Health, Harvard Pilgrim Health Care, Tufts Health Plan.
Point32Health is the parent company of Harvard Pilgrim Health Care and Tufts Health Plan, formed when the two carriers merged in 2021. It is the second-largest health plan in New England, with members across Massachusetts, New Hampshire, Maine, Connecticut, and Rhode Island. If you contract under the Harvard Pilgrim or Tufts Health Plan name, you are contracting with Point32Health.
DataLily Insights shows you how Point32Health pays. Rose, the AI analyst, answers in plain language. Ask how the plan reimburses a given CPT or HCPCS code in your market, how its negotiated and allowed amounts compare to peer payers, and where you may be underpaid. Built on more than 100 billion data points and covering over 10 million providers, the platform turns a complex regional payer into clear, code-level answers.
Because Harvard Pilgrim and Tufts run different plan lines and products, rates are not uniform. DataLily Insights separates the brands and the markets so you see what each pays, not a blended average that hides the real number.
What Insights reveals
What DataLily Insights reveals about Point32Health
Every benchmark below runs across more than 100 billion data points spanning over 10 million providers, so you see Point32Health the way the market actually pays.
Negotiated and allowed rates by CPT and market
See what Point32Health pays for a specific CPT or HCPCS code in your state and metro. Rose breaks out negotiated rates and allowed amounts across the Harvard Pilgrim and Tufts Health Plan lines, so you can see where the plan pays richer or leaner and how that shifts from Massachusetts to New Hampshire, Maine, Connecticut, or Rhode Island.
Payer mix and share
Understand how much Point32Health weight sits in your book of business and in your market. As the second-largest plan in New England, it can be a large share of outpatient and surgical volume. DataLily Insights shows the plan's footprint among your peers so you know how much a Harvard Pilgrim or Tufts contract really moves.
Geographic and specialty strength
Point32Health is concentrated in New England, and its strength varies by state, product line, and specialty. Rose shows where the plan is dense and where it thins out, and how its reimbursement stacks up by specialty, so you can see whether your service lines align with where this payer pays well.
Are you underpaid versus peers
Compare your Point32Health rates against market and peer benchmarks for the same codes. DataLily Insights flags where Harvard Pilgrim or Tufts pays you below comparable groups in your region, giving you a clear, code-level view of whether you are underpaid versus peers before your next contract conversation.
Ask Rose
Questions to ask Rose about Point32Health
Rose answers in plain language, charts the result, and ends with a recommendation. Bring one of these to a demo.
FAQ
Point32Health reimbursement, answered
Who owns Harvard Pilgrim and Tufts Health Plan?
What states does Point32Health cover?
How can I see what Point32Health pays for a specific CPT code?
How do I know if Point32Health is underpaying my group?
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