History of Fallon Health

Here's a timeline of events in the history of Fallon Health.

1977

  • Fallon Community Health Plan is founded.

1979

  • FCHP receives first state contract to cover Medicaid recipients.

1994

  • FCHP is first HMO in state to receive accreditation from National Committee for Quality Assurance (NCQA)*.

1995

  • Fallon Health establishes Elder Services Plan, the region’s first comprehensive health care program for the elderly in Worcester, Mass.

2005

  • Elder Service Plan officially changes its name to Summit ElderCare.

2006

  • Summit ElderCare expands with the opening of a new site in Charlton.
  • FCHP becomes one of four managed care organizations to participate in Massachusetts' new Commonwealth Care health insurance program.

2007

  • Summit ElderCare expansion continues with the opening of a new site in Leominster.

2008

  • Summit ElderCare opens a second facility in Charlton, Mass., and a second facility in Worcester, on Grafton Street.


2009

  • FCHP expands service area to Southern New Hampshire to provide greater access for Massachusetts-based companies that have employees living in New Hampshire.
  • FCHP introduces NaviCare HMO, a Senior Care Options/Medicare Advantage Special Needs program.

2010

  • Summit ElderCare becomes largest PACE program New England.
  • FCHP introduces Medicare Supplement health insurance options.

2011

  • FCHP announces the expansion of NaviCare to MetroWest, Middlesex County and western Mass.

2012

  • FCHP announces expansion of Fallon Senior Plan and NaviCare service areas—the largest service area expansion in FCHP history. As of January 2013, both are available to eligible residents in Barnstable, Bristol, Essex, Hamden, Hampshire, Middlesex, Norfolk, Plymouth, Suffix and Worcester counties, and portions of Franklin County.

2013

  • FCHP is the first health insurer in the state to offer the convenience of a Mobile ID card to members.
  • FCHP opens its fifth Summit ElderCare in Springfield. The western Mass. service area includes Hampden County and the towns of Granby, Easthampton, Southampton and South Hadley.
  • FCHP opens a faculty and student wellness center on the College of the Holly Cross campus that is staffed daily by an FCHP Health Educator.

2014

  • Fallon Community Health Plan rebrands as Fallon Health to reflect its evolving business in the rapidly changing health care industry.
  • Fallon announces a joint venture with Weinberg Campus, the largest aging health campus in western New York (Erie County), to create Fallon Health Weinberg. Together, the company reaches many of the most vulnerable residents in western New York with a holistic, person-centered, integrated approach to care.

2015

  • Fallon announces that its wholly owned subsidiary, UltraBenefits Inc., acquired third-party administrator Group Insurance Center Inc., (GISC) of Pembroke, Mass. expanding membership by 17,000.
  • Fallon Senior Plan and NaviCare both receive 4.5 star ratings (out of a possible 5 stars) from CMS for its 2015 Medicare Advantage and Medicare Part D Star Ratings program.
  • Fallon is named in the top 10% of health plans in America for 2015 - 2016. Based on ratings by NCQA, Fallon's commercial (private) and Medicaid plans receive a 4.5 rating (out of 5) and Medicare a 4.0.

2016

  • Fallon expands Summit ElderCare, opening a Program of All-inclusive Care for the Elderly (PACE), on D'Youville Campus in Lowell. Fallon now operates six PACE sites in Massachusetts: Charlton, Leominster, Lowell, Springfield and Worcester (two).
  • Fallon opens a PACE program at Fallon Health Weinberg in western New York.
  • Fallon Senior Plan and NaviCare both receive 4.5 star ratings (out of a possible 5 stars) from the Centers for Medicare and Medicaid Services (CMS) for its 2015 Medicare Advantage and Medicare Part D Star Ratings program.  
  • Fallon is one again rated as one of America's top health plans. Based on ratings by NCQA, Fallon's commercial (private) and Medicaid plans receive a 4.5 rating (out of 5) and Medicare a 4.0. 

2017

  • Formed MassHealth Accountable Care Organizations (ACO) with the following provider groups:
  • Berkshire Health Systems and Community Health Programs
  • Reliant Medical Group
  • Wellforce, and its provider partners, and Lowell Community Health Center

2018

  • Fallon recorded its highest membership ever after launching three MassHealth ACO Partnership Plans in March



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

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