Q&A: UMass Memorial insurance plans

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Marie Hsieh
  • Title: CEO
  • Society: Mass Advantage, in Worcester
  • Foundation year: 2021
  • Employees: 15, with significant growth projects
  • Hsieh’s age: 50
  • Place of birth: Taiwan
  • Residential homes: Worcester and Atlanta
  • Education: Bachelor of Biochemistry from the University of California – Davis; master’s degree in public health from UC Berkeley; Doctor of Pharmacy from UC San Francisco

More information

In September, Mary Hsieh became the first CEO of the new company Mass Advantage, the insurance offered by Worcester healthcare provider UMass Memorial Health and its partners, Shields Managed Care Solutions, LLC in Stoughton, and WCAS CM Holdings. Delaware LLC. The insurance is available to all Medicare-eligible residents of Worcester County and is known as the Medicare Advantage plan, which offers more benefits than government health insurance. Coverage for first-time members begins January 1.

How is your team feeling as January 1 approaches?

It’s incredibly energizing to build something from scratch. You are not really inheriting the baggage of an existing infrastructure with a historic past. Everyone on the team feels that we could be doing something really different from other Medicare Advantage plans.

Coming out of the coronavirus pandemic, people will also support what matters. This crisis has really taught us what is important, and we can anchor Mass Advantage to what really matters.

So what really matters?

From a member’s perspective, it’s: When can I see my doctor? Can I access care when I need it? Will my insurance make it easier? Will I be able to access the latest medical advances?

It should be a simple answer, but it is not currently. At present, the insurance process is not making life easier for patients. It does not make life easier for providers either.

From the provider’s perspective: Doctors are busy fighting the pandemic and they want to see change. We did a listening tour to find out the pain points for doctors and other providers.

How to make their life easier?

This is where UMass Memorial Health becomes so important in what we do. Working so closely with a provider like this allows us to be very specific about the benefits we provide to our patients.

For example, the Hospital at Home program was developed by UMass Memorial Health to ensure that some people receive hospital care in the comfort of their own homes. This is designed specifically for the community, and we can bring that to our members, because we want them to use this service.

The amount of enthusiasm and interest in something like this wrapped around a UMass Memorial Health system has been exceptional. I know we are going to do great things together.

Can patients be treated only at UMass Memorial Health?

No. Although we are anchored by UMass Memorial Health, Mass Advantage has a very large network. There are HMO and PPO options, and our members can use a number of healthcare providers.

Is this type of insurance modeled on anything?

Medicare Advantage plans have seen tremendous growth across the country. Anyone who is eligible for Medicare can choose a Medicare Advantage plan, which will provide benefits at least equal to Medicare, with the option of offering many more. We can offer comprehensive dental plans, full vision coverage. Our members can purchase over-the-counter health products on the plan.

Unlike traditional Medicare where patients will still be responsible for part of their care, Medicare Advantage plans have caps on how much patients have to pay.

How is the Advantage package market evolving?

There has been a big bump due to aging baby boomers in a Medicare-eligible window, and more members want to use a Medicare Advantage plan. Right now, 39% of Medicare-eligible people in Worcester County are using a Medicare Advantage plan, so there’s a lot more market share.

Will Mass Advantage grow quickly once launched?

Yes, because we are building a great program. Our management team has significant experience. I have helped a number of health plans develop their health insurance plans across the country so I know what patients and providers are looking for.

This is not our first tour to do this, for our entire management team.

This interview was conducted and edited for length and clarity by WBJ Editor-in-Chief Brad Kane.


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