Fallon Health earns top national recognition in NCQA Health Plan Ratings
Rated 4.5 out of 5—no other Medicaid plan in Massachusetts received a higher rating
Worcester, Mass., September 16, 2025— Fallon Community Health Plan (Fallon Health), a nationally-recognized, not-for-profit health care services organization, today announced it has earned a 4.5 out of 5 rating in the NCQA Health Plan Ratings 2025: Medicaid. This latest recognition continues Fallon Health’s longstanding track record of excellence, with multiple years* of earning top-tier ratings from NCQA. The organization is 1 of only 2 Medicaid plans in Massachusetts to earn this distinction and is among the top 5 percent of Medicaid plans nationally, based on NCQA’s evaluation of 276 plans.
“This recognition is a reflection of our deep commitment to the communities we serve,” said Manny Lopes, President and CEO of Fallon Health. “It speaks to the compassion and dedication of our teams, the strength of our provider partnerships, and our unwavering focus on delivering care that improves lives and advances health equity for every member.”
The National Committee for Quality Assurance (NCQA) is a private, nonprofit 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 website (https://www.ncqa.org/) contains information to help consumers, employers, and others make informed health care choices.
According to NCQA’s Health Plan Ratings released September 15, 2025, no Medicaid plan received a 5-Star rating, and only 14 earned a 4.5-Star rating. Fallon Health was among the14, and no Medicaid plan in Massachusetts received a higher rating.
Fallon Health is also proud to be among the early adopters of NCQA’s Health Equity Accreditation (2023-2027), a distinction that underscores its commitment to delivering care that is inclusive, respectful, and responsive to the diverse needs of its members.
Fallon Health was the first health plan in Massachusetts to receive a state contract to serve Medicaid recipients in 1979. Today, the organization continues to advance its mission by partnering with leading providers to deliver high-quality, cost-effective, and equitable care to MassHealth members across its service area. Fallon Health currently serves more than 92,000 members through its 3 Medicaid plans: Berkshire Fallon Health Collaborative, Fallon 365 Care, and Fallon Health-Atrius Health Care Collaborative.
*Fallon Health earned a 4.5 out of 5 rating in NCQA’s Health Plan Ratings: Medicaid for the following years: 2019, 2020, 2021, 2022, 2023, 2024, and 2025. Please note NCQA did not publish Health Plan Ratings in 2020 due to the COVID-19 pandemic. Fallon Health’s 2020 score is based on the previous year’s performance.
Fallon Health contact:
Melissa Randall
Director, Corporate Communications
Fallon Health
508-368-9345
melissa.randall@fallonhealth.org
About Fallon Health
Fallon Health is a mission-driven, not-for-profit, health care services organization based in Worcester, Massachusetts. For nearly 50 years, we’ve been improving health and inspiring hope in the communities we serve. Committed to caring for those who need us most, we pride ourselves on providing equitable access to coordinated, integrated care for our members with a special focus on those who qualify for Medicare and Medicaid. We also serve as a provider of care through our Program of All-Inclusive Care for the Elderly (PACE). Dedicated to delivering high quality health care, Fallon Health is continually rated among the nation’s top health plans for member experience, service, and clinical quality.
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. NCQA’s website (ncqa.org) contains information to help consumers, employers and others make informed health care choices. NCQA can also be found at Twitter/X @ncqa and on LinkedIn at linkedin.com/company/ncqa.