Fallon Community Health Plan reports third quarter financials

Worcester, Mass., November 13, 2009—Fallon Community Health Plan (FCHP) today reported a net loss of $13.4 million on revenue of $283 million for the third quarter, ending September 30, 2009. Year-to-date net loss is $16.3 million on revenue of $831 million. Net loss for the third quarter includes investment income of $3.2 million and an operating loss of $16.6 million. For the same quarter last year, FCHP posted a net income of $5.7 million on revenue of $265 million. Net income included investment income of $1.5 million and operating income of $4.2 million. Membership was 224,708 for the third quarter, ending September 30, 2009, compared to 215,963 for the same quarter last year.

“Our results show that we’re not immune to the economic challenges Massachusetts is facing,” said Charles Goheen, FCHP’s Chief Financial Officer. “Several factors are at play, including inadequate reimbursements from the state and federal governments, which are happening at a time when medical costs continue to escalate. We’re also seeing a higher than anticipated volume of claim activity, particularly within the merged individual and small group market.”

Goheen also said that, despite these challenges, FCHP remains focused on two significant areas: continuing to operate in the most cost-efficient manner possible and delivering on its commitment to ensure FCHP members receive the highest quality of care and services.

“We continue to work hard to ensure that, on average, 90 cents of every premium dollar we receive goes directly to pay for the cost of medical care,” said Goheen. “FCHP also has just been recognized as one of the top 10 health plans in America for clinical quality and customer satisfaction.”

Recent achievements and news from Fallon Community Health Plan include:

• Recognized as one of the country’s top 10 health plans -- and the only health plan in America to achieve Honor Roll status in all three product categories (commercial, Medicare and Medicaid) -- in a joint ranking by U.S. News and World Report and the National Committee for Quality Assurance. In addition, FCHP is the highest-ranked Medicare health plan in Massachusetts.
• Announced the launch of a unique, new product, called NaviCareSM HMO, which is a Senior Care Options product. NaviCare HMO supports the health care needs of those age 65 and over in Worcester County who are enrolled in MassHealth Standard. It combines in one package all Medicare and Medicaid benefits, as well as additional benefits and services designed to promote independence and quality of life.
• Recognized by Pioneer Institute with “Special Recognition” in the Institute’s 2009 Better Government Competition.
• Held the Fourth Annual Golf FORE a Goal tournament and raised more than $150,000 for food pantries and hunger relief programs throughout the FCHP service area.
  

NCQA is a private, non-profit organization dedicated to improving health care quality.

Lauren M. Petit
lauren.petit@fchp.org