Insurer spends $4m to make break from doctors clear

In the 1990s, Harvard Vanguard Medical Associates, the big doctors group, was part of Harvard Pilgrim Health Care, the big health insurer.

Harvard Pilgrim would like you to forget all about that slice of history, and it's spending $4 million on the company's largest advertising campaign of the year to drive home the point.

Turns out that many Massachusetts residents still associate the two organizations with each other, even though they went through a formal divorce in 2004. In fact, some people still think that if they join a Harvard Pilgrim health plan, they have to see Harvard Vanguard doctors.

"It's time to put this issue to bed," said Dana Rashti, vice president of marketing for Harvard Pilgrim Health Care, the state's second-largest health insurer with about 1 million members. "At one point, we had health centers and you had to go to our health centers. But for the past 10 years, our members have had access to physicians throughout New England."

Harvard Pilgrim launched the promotional campaign this week with print ads, television spots, and outdoor advertising including billboards. Some print ads have appeared in The Boston Globe. Television ads feature Melina Kanakaredes, the actress who starred in the television show "Providence."

The ads seek to portray the Harvard Pilgrim membership card as a ticket to healthcare without restrictions. "Harvard Pilgrim is not a building. We are not a health center," one ad says. "We are a health plan that lets you choose your doctor and where to get care."

Harvard Vanguard, the doctors group, has another identity problem. It is now part of a group of medical practices that changed its name in May to Atrius Health. Atrius is starting its own ad campaign to explain that Harvard Vanguard is now part of the larger group. The Newton not-for-profit includes Dedham Medical Associates, Southboro Medical Group, South Shore Medical Center, and Granite Medical in Quincy.

"We also want people to learn about our affiliation with Atrius Health, an alliance of medical groups with a commitment to better ways of keeping people healthy," said Debra Geihsler, who serves as chief executive of both Harvard Vanguard and Atrius, in a statement.

The two campaigns show how what was once an asset in the healthcare business became a liability. In the early days of health maintenance organizations, insurers set up closed networks of participating physicians. Patients often found it challenging to find a plan that accepted doctors they might have been seeing for years.

Harvard Pilgrim, then known as Harvard Community Health Plan, assembled an in-house physicians group with large medical practices throughout the Boston area. The quality of those practices became a calling card for the health plan.

But increasingly through the 1980s and 1990s, consumers rejected the tight controls of so-called managed care, demanding greater freedom to choose their healthcare providers. In the late 1980s, Harvard Pilgrim's members were permitted to see doctors from other physician groups. In 1998, the Harvard physician group began to call itself Harvard Vanguard. In 2000, the practices began accepting members of Tufts Health Plan and Blue Cross Blue Shield of Massachusetts - Harvard Pilgrim's largest competitors. The organizations cut ties in 2004.

Atrius is placing ads on buses and trains and in transit stations with the tag line, "A better approach to your health." For a year, it has displayed brochures and signs in medical offices saying that its doctors accept patients from many health plans.

The confusion has also created some inconveniences. Transport buses with people in wheelchairs occasionally turn up at Harvard Pilgrim's main office building in Wellesley, and another in Quincy, and the insurer's telephone operators sometimes field requests to make appointments for doctors.

Jeffrey Krasner can be reached at krasner@globe.com.