Fallon Health achieves national rating
Fallon Health named among highest-quality Medicaid health plans in America; no other Massachusetts health plan rated higher.
Worcester, Mass., September 25, 2024— Fallon Health, a nationally-recognized, not-for-profit health care services organization, today announced that it has once again achieved a rating of 4.5 out of 5 in NCQA’s Health Plan Ratings 2024: Medicaid. Notably, the achievement puts Fallon Health among the top 14 Medicaid plans nationally.
“Prioritizing our members and making sure they get the care and services they need and deserve is something we take seriously at Fallon Health,” said Lora Council, M.D., Interim Chief Medical Officer. “We’re honored by this recognition which speaks volumes about the innovative, quality-driven, and collaborative care management solutions we provide in partnership with providers throughout the state.”
NCQA, a private, non-profit organization dedicated to improving health care quality, provides Health Plan Ratings annually to help consumers, employers, and others better understand the quality of care that health plans provide to their members. In 2024, 201 Medicaid plans were evaluated nationwide. No plans received 5 stars, and 14 plans achieved 4.5 stars. No Massachusetts Medicaid plans were rated higher than Fallon Health.
“Ensuring high quality and excellence is the basis of everything we do,” said Matt Herndon, Senior Vice President and Chief State Programs Officer. “We’re proud to consistently be rated among the best Medicaid health plans in the country, including back-to-back years in 2023 and 2024. It’s a testament to Fallon Health’s commitment to serving this important population, which is consistent with our history and mission.”
Fallon Health was the first health plan in Massachusetts to receive a state contract to cover Medicaid recipients in 1979. Today, in alignment with its vision of being the leading provider of government-sponsored health insurance programs, the organization partners with leading providers to provide members with MassHealth in Eastern and Central Massachusetts and the Berkshires with access to high-quality, lower-cost, equitable care. Approximately 70 percent of Fallon Health members are enrolled in Medicaid.
Fallon Health contact:
Melissa Randall
Director, Corporate Communications
Fallon Health
508-368-9345
melissa.randall@fallonhealth.org
About Fallon Health
Fallon Health is a company that cares. We prioritize our members—always—making sure they get the care they need and deserve. Founded in 1977 in Worcester, Massachusetts, Fallon delivers equitable, high-quality coordinated care and is continually rated among the nation’s top health plans for member experience, service, and clinical quality. Today, guided by our mission of improving health and inspiring hope, we strive to be the leading provider of government-sponsored health insurance programs—including Medicare, Medicaid, and PACE (Program of All-Inclusive Care for the Elderly).
About NCQA
NCQA is a private, nonprofit organization dedicated to improving health care quality. NCQA accredits and certifies a wide range of health care organizations. It also recognizes clinicians and practices in key areas of performance. NCQA’s Healthcare Effectiveness Data and Information Set (HEDIS®) is the most widely used performance measurement tool in health care. In recognition for its leadership in diversity, equity and inclusion, NCQA has won the Excellence in Diversity Award from the Chesapeake Human Resources Association. NCQA’s website (ncqa.org) contains information to help consumers, employers and others make more-informed health care choices. NCQA can be found online at ncqa.org, on Twitter @ncqa, and on LinkedIn at linkedin.com/company/ncqa