Fallon Health celebrates 40th anniversary

Worcester, Mass., June 23, 2017 ―  Fallon Health celebrates its 40th anniversary this year as it continues the health care innovation that has been the hallmark of its history. Founded in 1977 as a local community health plan with one location in Worcester, Fallon is now a nationally recognized not-for-profit health care services organization with 10 locations throughout Massachusetts and western New York. Fallon has been consistently rated in the top 10 percent of health plans in the nation by the National Committee for Quality Assurance (NCQA)*.

Fallon’s very creation was an innovation. Health care leaders in central Massachusetts wanted to bring together all components of the health care system so that we could work together to provide high-quality care at an affordable cost. The result was Fallon Community Health Plan, a provider-payer partnership launched by Fallon Clinic, which is now Reliant Medical Group. Fallon became an independent health care organization in 2004 (and shortened its name to Fallon Health in 2014), expanding its system of integrated care by partnering with a wider range of providers.

Fallon has been a leader in the health insurance industry throughout its existence:

  • In 1980, it became the first HMO in the country to offer a Medicare plan.
  • In 1995, Fallon became the first health plan in the country to offer a Program for All-Inclusive Care for the Elderly (PACE), and in 2008, became one of the few commercial health insurers in Massachusetts to offer a Senior Care Options (SCO) plan.
  • In 2002, Fallon was the first plan in Massachusetts to offer a limited network, which provides affordable care by emphasizing the use of high-quality, community-based providers.
  • Before risk-sharing between providers and health plans became a mainstream practice, Fallon was striking innovative risk-sharing arrangements with hospitals.
  • Fallon was the first—and still the only—health plan in Massachusetts that is both an insurer and a provider.

“Our ability to innovate is both our heritage and our future,” said Richard Burke, President and CEO of Fallon Health, who is in his 19th year at Fallon. “We developed products and services for seniors ahead of the market, and have valued and invested in provider partnerships before they were fashionable. We will continue to pursue growing markets such as senior care and government programs with innovative approaches that will deliver great care at an affordable cost to our customers and individual members.”    

“Over the last four decades Fallon Health has played an important role in the health and well-being of those who live in central Massachusetts and beyond.  Along the way Fallon has earned its place as one of the top health plans in the country,” said David W. Hillis, Chairman and Chief Executive Officer of AdCare Hospital of Worcester, and chair of Fallon’s board.

“Beyond being an extraordinary health plan, Fallon Health has been an outstanding member of the community. Fallon’s PACE and SCO programs have helped thousands of seniors in our region to live independently and with dignity. And its employees and the company have been especially active in hunger relief efforts in Worcester and across the Commonwealth, building and supporting food pantries and feeding individual families. Congratulations on 40 amazing years. Here’s to forty more!” said U.S. Congressman Jim McGovern (D-MA).
Fallon has a number of activities planned to recognize its milestone, including a grant program called Pay It Forward that will distribute $40,000 to employee-nominated nonprofit community agencies.

National Committee for Quality Assurance (NCQA) is a private, non-profit organization dedicated to improving health care quality. NCQA accredits and certifies a wide range of health care organizations and recognizes clinicians in key clinical areas. NCQA's HEDIS® is the most widely used performance measurement tool in health care. NCQA's Web site (www.ncqa.org) contains information to help consumers, employers and others make more informed health care choices.



Carrie Wattu

About Fallon Health
Founded in 1977, Fallon Health is a leading health care services organization that supports the diverse and changing needs of those we serve. In addition to offering innovative health insurance solutions and a variety of Medicaid and Medicare products, we excel in creating unique health care programs and services that provide coordinated, integrated care for seniors and individuals with complex health needs. Fallon has consistently ranked among the nation’s top health plans, and is accredited by the National Committee for Quality Assurance for its HMO, Medicare Advantage and Medicaid products. For more information, visit www.fallonhealth.org.