Boston Medical Center (BMC) HealthNet Plan is a 501(c)(3) status health maintenance organization located in Massachusetts. Founded in 1997 by Boston Medical Center, the Plan contracts with providers and hospital systems throughout Massachusetts to deliver care to nearly 245,000 members. BMC HealthNet Plan is the largest health maintenance organization for both MassHealth and Commonwealth Care programs. The mission of BMC HealthNet Plan is to be a quality and cost effective provider-sponsored health maintenance organization supplying excellent care coordination and services.

Provider oriented
BMC HealthNet Plan views its participating providers as partners in a commitment to clinical excellence for low-income individuals and families who are the providers’ patients and the Plan’s members. The Plan’s care-related policies are provider-driven. For example, the Plan requires no pre-authorizations for office visits to participating specialists. In addition, to better serve its members -- and provider network -- BMC HealthNet Plan has offices in Boston (our main office), as well as in New Bedford, Springfield and Pittsfield. Our goal is to ensure local support in all regions where we provide coverage.

Coordinated care
Each BMC HealthNet Plan member selects a personal primary care provider (PCP) who delivers or arranges for the member’s care. All approved PCP services, inpatient admissions and outpatient visits are covered. The Plan also offers special care management programs for members who are pregnant or who have asthma, diabetes, depression, coronary artery disease, chronic obstructive pulmonary disease or congestive heart failure. Members can also benefit from the Plan’s behavioral health care management services.

A network of 16,000 providers
Our provider network includes 60 acute care hospitals, 3,000 primary care physicians and nearly 12,000 specialists and ancillary providers, as well as 1,000 pharmacies.

Recognized for quality
In 2009, BMC HealthNet Plan earned the highest possible accreditation (“Excellent”) for its MassHealth Plan from the National Committee for Quality Assurance (NCQA). BMC HealthNet Plan also earned the #2 rank among Medicaid plans in the nation (and highest-ranked in Massachusetts), according to the 2009-10 “America’s Best Health Insurance Plans” rankings by U.S. News and NCQA.