Fallon Health and Wellforce form Accountable Care Organization to improve health outcomes for MassHealth members


Worcester, Mass., August 17, 2017 ― Wellforce and its provider organizations in partnership with Fallon Health, will offer a new managed care option—Wellforce Care Plan—
for MassHealth members. The creation of Wellforce Care Plan is part of the state’s reform of MassHealth to include Accountable Care Organizations (ACO) in which physicians, hospitals, insurers and other health care providers work together to provide integrated care with the goals of improving health outcomes and containing costs.

Effective March 1, 2018, MassHealth members identified by the Executive Office of Health & Human Services (EOHHS) as being a patient of certain primary care providers (PCP) at Lowell Community Health Center, New England Quality Care Alliance, Tufts Medical Center, Hallmark Health, and Circle Health (Lowell PHO) will be enrolled in Wellforce Care Plan. MassHealth is a state-administered Medicaid program—funded by the state and federal governments—that provides health care to eligible people who need health coverage.

“With our experience providing integrated care through other government programs, Fallon Health is perfectly positioned to provide care under the ACO model,” said Richard Burke, President & CEO of Fallon Health, referring to Fallon Health’s Program of All-inclusive Care for the Elderly (PACE) – Summit ElderCare – and Senior Care Options/Special Needs Plan –NaviCare. “We believe this approach will help reduce fragmented care, improve health outcomes and contain costs.”

“We’re pleased to partner with the many outstanding providers that make up Wellforce to provide high-quality, highly coordinated care,” he added.

A key component of ACOs like Wellforce Care Plan is the utilization of community-based health and social service organizations to improve behavioral health care, put in place long-term supports and address health-related social needs—all of which contribute to better health outcomes.

“When Tufts Medical Center, Circle Health and Hallmark Health joined together as Wellforce, we made a commitment to helping the state lower health care costs and to enhancing the services and care we provide in our communities. The Wellforce Care Plan furthers that mission. I know our patients will benefit greatly from this partnership with Fallon Health and the Commonwealth,” said Norm Deschene, CEO, Wellforce.

To enroll in Wellforce Care Plan, individuals must live in the Wellforce Care Plan service area, which includes the Merrimack Valley, the North Shore, and parts of Boston and the South Shore. More information about Wellforce Care Plan will be available in the fall at fallonhealth.org/wellforce.

Carrie Wattu
Fallon Health
Corporate Communications Manager

Brooke Hynes
Vice President, Marketing and Communications

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 fallonhealth.org.

About Wellforce
Wellforce is the health system formed by Tufts Medical Center and Circle Health in 2014. On January 1, 2017, Hallmark Health will become the third founding member. Wellforce provides hospitals and physicians with a better option for collaboration. Our system brings together the strengths of academic medicine and community care in a model that respects both equally. Our independent-minded, value-driven members are dedicated to providing patients with the highest-level of care when and where they want it. Wellforce includes nearly 3,000 physicians, 12,000 employees, four community hospital campuses, one academic medical center, a children’s hospital and $1.7 billion in revenue.