Tufts Medicine and Blue Cross Blue Shield of Massachusetts announce collaboration to expand access to care and streamline prior authorization. BOSTON, Oct. 22, 2026 /PRNewswire/ - Blue Cross Blue Shield of Massachusetts ("Blue Cross") and Tufts Medicine today announced a strategic collaboration designed to reshape how patients across Massachusetts access and experience care. Rooted in a shared commitment to connecting patients with the right care at the right time, the initiative enhances a traditional payer-provider relationship to address what matters most: expanding access to primary and specialty care, improving affordability and reducing clinician administrative burden. Simplifying prior authorization A central example of this multi-faceted work is streamlining the prior authorization process. Tufts Medicine will use the Humata Health solution to more rapidly process prior authorizations for Blue Cross members for select imaging services, including MRIs, with plans to expand to additional services. By transmitting required information in minutes rather than days, clinicians spend less time navigating prior authorization and more time caring for patients. The Humata implementation is part of a broader collaboration supported by the Massachusetts Health Data Consortium (MHDC), which operates the New England Healthcare Exchange Network (NEHEN), a regional health information exchange infrastructure. Through NEHEN FHIR(R), Blue Cross and Tufts Medicine aim to enable the more seamless exchange of clinical and administrative data needed to support member care, referrals and claims processing Expanding access to affordable care Another example of how this collaboration is tackling some of healthcare's biggest challenges is the introduction of an innovative healthcare option that will be offered to Blue Cross employees during its upcoming open enrollment. The newly-created Tufts Medicine Alliance Network (HMO) will be offered as part of employees' plan choices. Designed to deliver coordinated, affordable care, this option offers access to a select network of high-quality providers - including Tufts Medicine, Boston Children's Hospital and Dana-Farber Cancer Institute. Participating employees will benefit from next-day access to primary care, dedicated navigation support for individual member care needs, both digitally and through their dedicated care team, and the ability to see a Tufts Medicine specialist within 21 days. Both organizations are working together to develop similar offerings for additional customers and patients in the future. Driving systemic change Reducing administrative burden through prior authorization automation and introducing a new HMO offering for Blue Cross employees is part of a broader collaboration spanning other areas of healthcare. Additional work includes: * Driving affordability through expanded payment models: Blue Cross and Tufts Medicine are working to design and implement next-generation value-based payment models that support high-quality care while lowering overall costs. This effort builds on Tufts Medicine's long-standing participation in Blue Cross' Alternative Quality Contract (AQC). * Transforming how care is delivered: The organizations are developing approaches to provide patients with faster access to both in-person and virtual care across the Tufts Medicine Integrated Network, including primary and specialty care. These efforts include expanding primary care capacity, integrating mental health services, enhancing after-hours urgent care access within the care team and improving turnaround time to specialty and ancillary referrals. The goal is to translate these new clinical approaches into improved access and experience for the members and patients each organization serves. As part of this collaboration, Blue Cross and Tufts Medicine are investing in innovative solutions - such as technology, data analytics and other capabilities - that address the administrative and access challenges facing both organizations. What they're saying: * Sarah Iselin, Blue Cross' president and CEO: "Our two organizations share a mutual commitment to improving how healthcare works. It's going to take bold action to make it more affordable, easier to navigate and fundamentally less frustrating for individuals and families seeking care and for providers navigating administrative processes. This is the critical work ahead, and I'm excited to work with Tufts Medicine to build a better system together." * Phil Okala, Tufts Medicine's acting president and CEO: "For too long, clinicians have spent enormous time and energy navigating administrative processes. This collaboration gives us a real path to change that-reducing friction in how we operate so our teams can focus on what they do best: providing a world-class experience for the patients we serve. The trust we've built with Blue Cross makes that kind of meaningful, lasting change possible." * Jeremy Friese, MD, founder and CEO of Humata Health: "We are proud to work with Blue Cross Blue Shield of Massachusetts and Tufts Medicine to remove friction from the prior authorization process. That's why Humata Health was founded. Less friction and faster decisions mean patients get the care they need sooner, and physicians spend more time with patients than paperwork." About Blue Cross Blue Shield of Massachusetts Blue Cross Blue Shield of Massachusetts (bluecrossma.org) is a community-focused, tax-paying, not-for-profit health plan headquartered in Boston. Blue Cross MA is committed to showing up for everyone like they're the only one and guiding its members to the exceptional healthcare they deserve - affordably, equitably and seamlessly. In keeping with its commitment, Blue Cross MA is rated among the nation's best health plans for member satisfaction and quality. Connect with Blue Cross MA on Facebook, Instagram, and LinkedIn. About Tufts Medicine Tufts Medicine, the primary health system of Tufts University School of Medicine, brings together academic medicine and community-based care to deliver exceptional, connected and accessible services. The system includes Tufts Medical Center, Lowell General Hospital, MelroseWakefield Hospital, Lawrence Memorial Hospital of Medford, Tufts Medicine Care at Home and Tufts Medicine Behavioral Health Hospital. Supported by a network of 3,500 physicians and advanced practice clinicians, Tufts Medicine treats complex conditions, advances research and improves health in the communities it serves. About Humata Health, an R1 Company Humata Health is a leader in AI-powered, touchless prior authorizations. A health tech company "Built for Yes," its mission is to make prior authorization easy and seamless for providers, payers and the patients they serve. With the industry's largest ecosystem of integrations and proprietary technology that gathers the right clinical information required for fast approval, the Humata platform is the only truly end-to-end prior authorization solution for all services and procedures. A physician-led company, Humata was recently acquired by R1, an industry leader in healthcare revenue management. SOURCE Blue Cross Blue Shield of Massachusetts For further information: Kelsey Pearse, [email protected]

A history of partnership and growth. The Boston Dispensary and Suffolk Dispensary became Tufts College Medical School's first teaching affiliates in 1894, beginning a partnership that would define the institution's academic mission. In 1929, the Boston Dispensary, the Boston Floating Hospital for Children, and the Trustees of Tufts College formed an alliance to establish the New England Medical Center. In 1946, the Pratt Diagnostic Clinic joined the partnership, and in 1968 the affiliated organizations were formally organized as Tufts New England Medical Center. In 2008, the name was shortened to Tufts Medical Center to better reflect the hospital's close relationship with Tufts University. Today, Tufts Medical Center is an academic medical center and Level I trauma center that provides care in more than 100 specialties, from heart care and cancer treatment to neuroscience, orthopedics and organ transplantation. Since 2000, it has performed more adult heart transplants than any other center in New England, and in 2024 set a New England record with 70 adult heart transplants in a single calendar year. Tufts Medical Center is the first hospital in New England to receive the highest-level accreditation for excellence in older adult care, and has earned Magnet(R) recognition for nursing excellence. Tufts Medical Center is part of Tufts Medicine, an integrated academic health system that also includes Lowell General Hospital, MelroseWakefield Hospital and Tufts Medicine Care at Home. Pediatric services continue as Tufts Medicine Pediatrics in collaboration with Boston Children's Hospital.

Tufts Medicine names Nic Nguyen, MD as the physician enterprise's inaugural Chief Clinical Officer + Chief Integration Officer. September 23, 2026 Appointment will enhance patient access to primary and specialty care through a community-based, integrated care delivery model Tufts Medicine today announced the appointment of Nic Nguyen, MD, as Chief Clinical Officer and Chief Integration Officer. As one of the most respected primary care physicians and clinical leaders in Massachusetts, Dr. Nguyen will support an important element of Tufts Medicine's vision to build the primary care enterprise in a coordinated, and patient-centered care delivery system across the continuum that empowers people. Dr. Nguyen started at Tufts Medicine in late August. In this inaugural role, Dr. Nguyen is the physician executive responsible for leading Tufts Medicine's employed community primary care teams, and in alignment with community-based primary and specialty care leaders, advancing a more integrated, systemwide ambulatory care strategy across Tufts Medicine. Dr. Nguyen will work closely with Tufts Medicine's senior executive team and the Tufts Medicine Integrated Network to drive growth, overall integration, care team experience and sustainability, clinical excellence and value-based care, while promoting the introduction and advancement of academic initiatives into the community. "As we work to strengthen integration between our private and employed physicians and advance our ambulatory strategy across Tufts Medicine, I am confident that Dr. Nguyen's breadth of experience in both academic and community-based settings will accelerate our ability to better reach and serve patients," said Dr. Erika Werner, Chief Physician Executive at Tufts Medicine, President of the Tufts Medical Center Physicians Organization, and Professor of Obstetrics and Gynecology, Tufts University School of Medicine. "We are honored to have Dr. Nguyen join our organization and enhance access to preventative and specialized care in the communities where our patients live." Dr. Nguyen joins Tufts Medicine from Beth Israel Lahey Health, where he served as Chief Medical Officer and Senior Vice President of the Medical Group. With demonstrated expertise in aligning clinical operations throughout complex health systems, Dr. Nguyen is also known for fostering physician and advanced practice clinician engagement and trust. Dr. Nguyen earned his Medical Degree from Tufts University School of Medicine and a Bachelor of Arts from Tufts University. He completed his Family Medicine residency at Cambridge Health Alliance-Tufts Family Medicine and the Linde Fellowship in Primary Care Leadership Program at Beth Israel Deaconess Medical Center. "Joining Tufts Medicine feels like a homecoming for me. It's where my academic journey began and where I started my clinical career, so I'm honored to return at such an important moment for the system," said Dr. Nguyen, who is also Assistant Professor, Tufts University School of Medicine, Family Medicine. "Together with Tufts Medicine's exceptional community-based clinicians and teams, I look forward to building an ambulatory care delivery model that advances operational and clinical excellence, expands patient access, and meets the evolving needs of patients now and in the future."