Neighborhood Health Plan of Rhode Island
- Company typePrivate
- Founded1993
- HeadquartersProvidence, United States
- Headcount501–1,000
- GTM typeB2C
- OfferingServices
Neighborhood Health Plan of Rhode Island firmographics
Firmographics- Name
- Neighborhood Health Plan of Rhode Island
- Legal name
- Neighborhood Health Plan of Rhode Island
- Website
- https://nhpri.org
- Company type
- Private
- Founded year
- 1993
- Operating status
- Operating
- Headcount range
- 501–1,000 employees
- Ownership category
- akta.pro rank
Neighborhood Health Plan of Rhode Island industry classification
Industry- Product category
- Managed Care Health Insurance
- SIC
- Hospital & Medical Service Plans (6324)
- akta.pro primary industry
- Medicaid Managed Care HMOs (HLAEAMAI)
Keywords
Where Neighborhood Health Plan of Rhode Island is headquartered
LocationHeadquarters
- HQ city
- Providence
- HQ country
- United States
- HQ region
- North America
Offices2 records
Markets served
Neighborhood Health Plan of Rhode Island business model
Business model- GTM type
- B2C
- Offering type
- Services
- Cost components
- Personnel, Operations, Technology or R&D, Marketing or Sales, Others
Revenue model
- Health Insurance Premium Revenue: The company generates revenue through premium payments from multiple sources: Medicaid managed care premiums (ACCESS/Rite Care, TRUST/Rhody Health Partners), Medicare Advantage D-SNP premiums (INTEGRITY for Duals, Dual CONNECT), and commercial health insurance premiums (individual/family plans and small employer group plans through HealthSource RI marketplace and direct enrollment).
Pricing tiers
| Model | Billing | Price |
|---|---|---|
| Subscription | Annual | 2026 premium rate requests ranging from 7.7% to 30.4% |
Go-to-market motion2 records
Distribution channels4 records
Marketing channels4 records
Neighborhood Health Plan of Rhode Island product offering
Product offeringCore offering
Neighborhood Health Plan of Rhode Island is a nonprofit 501(c)(3) HMO health plan providing managed care coverage to approximately 185,000 Rhode Island residents. It offers Medicaid plans (ACCESS/Rite Care, TRUST/Rhody Health Partners), Medicare-Medicaid dual eligible plans (INTEGRITY for Duals, Dual CONNECT), and commercial plans for individuals/families and small businesses. Plans bundle medical, behavioral health, pharmacy, dental, fitness, transportation, and supplemental benefits through partnerships with community providers and pharmacy benefit managers.
Product overview
Neighborhood Health Plan of Rhode Island is a nonprofit 501(c)(3) Medicaid managed care organization serving Rhode Island for over 30 years. The company offers a multi-product portfolio including Medicaid plans (ACCESS/Rite Care, TRUST/Rhody Health Partners), Medicare-Medicaid dual-eligible plans (INTEGRITY for Duals and Dual CONNECT), and commercial plans for individuals and small businesses. INTEGRITY for Duals is a FIDE SNP covering all Medicare and Medicaid benefits, while Dual CONNECT is an HMO D-SNP. Commercial products span multiple plan tiers (CHOICE, STANDARD, PREMIER, etc.) across individual/family and small business segments. Behavioral health services, a member portal, and pharmacy benefits are integrated across all plan types.
Differentiator
Problem solved
Functional benefit
Brands
- ACCESS - RIte Care: Medicaid managed care plan for members
- TRUST - Rhody Health Partners
- INTEGRITY for Duals
- Dual CONNECT
Products and services
- ACCESS – RIte Care
- TRUST – Rhody Health Partners
- INTEGRITY for Duals (HMO D-SNP)
- Dual CONNECT (HMO D-SNP)
- Individual & Family Plans
- Small Business Plans
- Behavioral Health Services
Companies that use Neighborhood Health Plan of Rhode Island
Customer profileNamed customers1 record
Segments4 records
Ideal customer profiles4 records
Neighborhood Health Plan of Rhode Island technology and API
TechnologyTechnology focussed No
API detail
- Has API
- Yes
- API docs
- API detail
Core technology
AI maturity
App detail
Integration6 records
Neighborhood Health Plan of Rhode Island partnerships and signals
Strategic signalPartnerships
Six partnerships are on record, tiered minor and core.
- Women & Infants HospitalminorNeighborhood awarded Women & Infants Hospital its first People4Equity designation, recognizing the hospital for facilitating accessible care that improves health outcomes for communities facing healthcare inequity. The evaluation criteria included staff training in trauma-informed care, implicit bias training, social determinant screenings, LGBTQIA+ support, language support, and maternal care access.
- CODAC Behavioral HealthcarecoreCODAC announced a new community health center at 45 Royal Little Drive in Providence. CODAC provides behavioral health services as part of Neighborhood's provider network.
- Delta Dental of Rhode IslandcoreINTEGRITY for Duals plan includes dental benefits through Delta Dental of Rhode Island, providing preventive and restorative dental coverage up to $1,250 annually including cleanings, oral exams and more through their extensive Rhode Island dental network.
- CVS CaremarkcoreCVS Caremark provides pharmacy benefit management services including mail order pharmacy, prior authorization processing, and Part D appeals and exceptions handling for Neighborhood's Medicare-Medicaid plans.
- YMCA of Greater ProvidencecoreNeighborhood provides Dual CONNECT members with YMCA membership and health tracking programs at no extra cost. Members gain access to group fitness classes, gym facilities, and wellness programs at YMCA locations throughout Rhode Island.
- Medical Transportation Management, Inc.coreNon-emergency medical transportation services provided through Medical Transportation Management, Inc. for INTEGRITY for Duals members to ensure access to medical appointments.
Scale indicators3 records
Recent moves7 records
Expansion highlights5 records
Neighborhood Health Plan of Rhode Island competitors and assessment
Company assessmentBroad incumbents
- Kaiser Permanente: Largest U.S. non-profit integrated HMO combining payer and provider functions. Comparable to NHPRI's non-profit HMO structure, integrated care philosophy, and mission orientation, though at vastly greater scale.
- Centene Corporation: The largest U.S. Medicaid managed care operator with extensive state contracts and growing Medicare presence. A benchmark for Medicaid managed care scale, MLR discipline, and government-program expertise relevant to NHPRI.
- UnitedHealthcare: Largest U.S. health insurer with significant Medicare Advantage, Medicaid, and commercial presence in Rhode Island (referenced in NHPRI's 2026 rate filing context). Competes head-to-head with NHPRI in D-SNP and commercial markets while offering broader national scale.
Direct peers
- Molina Healthcare: Pure-play government-sponsored healthcare insurer concentrated in Medicaid and Medicare programs, including D-SNPs. Highly comparable to NHPRI's product mix and government-contract dependency.
- CareSource: Non-profit Medicaid managed care plan with a mission-driven model and multi-state footprint. Directly comparable to NHPRI as a similarly structured, values-based government-program-focused insurer.
- Blue Cross & Blue Shield of Rhode Island: The other major Rhode Island-based health insurer, offering commercial, Medicare, and Medicaid products in the same geography as NHPRI. It is NHPRI's closest in-state competitor across multiple lines of business.
- AmeriHealth Caritas: Mission-driven, predominantly non-profit Medicaid managed care organization serving complex populations across multiple states. Closely comparable to NHPRI's Medicaid-centric, community-focused operating model.
Regional players
- Blue Cross Blue Shield of Massachusetts: Regional non-profit Blue plan serving Massachusetts with commercial and Medicare products. Comparable as a New England non-profit competitor with overlapping product portfolio and similar regulatory environment.
- Health New England: Non-profit regional HMO serving western Massachusetts with commercial and Medicare products. Comparable as a smaller, mission-driven regional HMO in the New England market with similar product mix and structural profile to NHPRI.
- Tufts Health Plan (Point32Health): Regional New England non-profit health plan offering commercial, Medicare, and Medicaid products across MA, RI, and CT. Directly comparable as a mission-driven regional HMO with overlapping product lines and geographies.
Market position
Strengths5 records
Weaknesses5 records
Competitive moat4 records
Key risks6 records
Key highlights7 records
Customer concentration
Neighborhood Health Plan of Rhode Island social profiles
Digital presenceNeighborhood Health Plan of Rhode Island compliance and trust
Trust signalCompliance4 records
Neighborhood Health Plan of Rhode Island financial estimates
Financial estimateRevenue estimate
Valuation estimate
Neighborhood Health Plan of Rhode Island leadership team
Management profileNumber of profiles
Profiles4 records
Neighborhood Health Plan of Rhode Island funding detail
Funding detailFunding overview
Funding rounds
Investors
Funding detail is available on the Subscription and Enterprise plan.Contact sales →
Neighborhood Health Plan of Rhode Island M&A and investment
M&A and investmentM&A
Investments
M&A and investment is available on the Subscription and Enterprise plan.Contact sales →
Frequently asked questions about Neighborhood Health Plan of Rhode Island
What does Neighborhood Health Plan of Rhode Island do?
Neighborhood Health Plan of Rhode Island is a nonprofit 501(c)(3) HMO health plan providing managed care coverage to approximately 185,000 Rhode Island residents. It offers Medicaid plans (ACCESS/Rite Care, TRUST/Rhody Health Partners), Medicare-Medicaid dual eligible plans (INTEGRITY for Duals, Dual CONNECT), and commercial plans for individuals/families and small businesses. Plans bundle medical, behavioral health, pharmacy, dental, fitness, transportation, and supplemental benefits through partnerships with community providers and pharmacy benefit managers.
Is Neighborhood Health Plan of Rhode Island a public or private company?
Neighborhood Health Plan of Rhode Island is a private company. It is classified as nonprofit foundation owned and is currently operating.
When was Neighborhood Health Plan of Rhode Island founded?
Neighborhood Health Plan of Rhode Island was founded in 1993. It employs 501 to 1,000 people.
Where is Neighborhood Health Plan of Rhode Island based?
Neighborhood Health Plan of Rhode Island is headquartered in Providence, United States, in the North America region.
How does Neighborhood Health Plan of Rhode Island make money?
One revenue line is on record: health Insurance Premium Revenue.
Who are Neighborhood Health Plan of Rhode Island's main competitors?
Broad incumbents on record are Kaiser Permanente, Centene Corporation and UnitedHealthcare. Direct peers are Molina Healthcare, CareSource, Blue Cross & Blue Shield of Rhode Island and AmeriHealth Caritas. Regional players are Blue Cross Blue Shield of Massachusetts, Health New England and Tufts Health Plan (Point32Health).
Does Neighborhood Health Plan of Rhode Island have an API?
Yes. NHPRI provides machine-readable files containing in-network negotiated rates and out-of-network allowed amount rates as required by the Price Transparency Final Rule (85 FR 72158). The data is published according to CMS schema version 2.0 specifications. Files include Medical In-Network, Medical Out-of-Network, and Table of Contents (TOC) files. For developers/data analysts, issues can be reported to [email protected]. Developer documentation is at files.nhpri.org/mrf/nhp/InNetwork.
What industry is Neighborhood Health Plan of Rhode Island in?
Neighborhood Health Plan of Rhode Island's product category is Managed Care Health Insurance. Its primary akta.pro industry code is HLAEAMAI, Medicaid Managed Care HMOs. Its SIC code is 6324.