History of Fallon Health

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

2016

  • Fallon is named Corporate Citizen of the Year by the Worcester Business Journal.
  • Fallon expands Summit ElderCare, opening a Program of All-inclusive Care for the Elderly (PACE) on D'Youville Campus in Lowell. Fallon operates six PACE sites in Massachusetts: Charlton, Leominster, Lowell, Springfield and Worcester (two).
  • Fallon opens a PACE program at Fallon Health Weinberg in western NY.
  • 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 the National Committee for Quality Assurance (NCQA), Fallon's commercial (private) and Medicaid plans receive a 4.5 rating (out of 5) and Medicare a 4.0. 

2015

  • Fallon celebrates the 20th anniversary of Summit ElderCare, its PACE program, and remains the largest PACE in New England.
  • Fallon introduces specialized plans to offer extra support for people with chronic conditions like asthma, diabetes and coronary artery disease.
  • 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 the Centers for Medicare and Medicaid Services for its 2015 Medicare Advantage and Medicare Part D Star Ratings program.  

2014

  • Fallon Community Health Plan rebrands as Fallon Health to reflect its evolving business in the rapidly changing health care industry.
  • Worcester Business Journal readers select Fallon as the winner of Best Health Insurance Provider (HMO/PPO) in Central Mass.
  • Based on rankings by the National Committee for Quality Assurance (NCQA), Fallon is in the top 10% of health plans in America for 2014-2015 for all three of its insurance offerings: Medicaid, Medicare and commercial rankings. Fallon is the #2 Medicaid plan in America out of 136 plans ranked. Fallon is ranked #22 for Medicare (out of 408 plans) and #34 for commercial (out of 507 plans).
  • 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 for its 2014 Medicare Advantage and Medicare Part D Star Ratings program.
  • Fallon introduces Community Care, a plan for individuals eligible for financial help for their health plan.
    Fallon launches Smart Shopper—Fallon’s transparency tool that also offers a financial incentive to members of up to $500, which is unique in the Mass. market.
  • Fallon introduces a new line of business, Plan Innovations, to serve organizations looking to improve the way health care is managed and delivered. The goal is to help partners to better coordinate care and reduce medical expenses. Plan Innovations offers consulting, administrative services, health plan business process outsourcing and joint venture partnerships.
  • 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.

2013

  • FCHP is the first health insurer in the state to offer the convenience of a Mobile ID card to our members.
    With the launch of the Healthy Health Plan, FCHP becomes the first carrier to include a wellness incentive program across our entire commercial product portfolio.
  • FCHP opens its fifth Summit ElderCare in Springfield and enrolls its first participant on June 1. 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 Holy Cross campus that is staffed daily by an FCHP Health Educator.
  • For the sixth time in seven years, FCHP is ranked by NCQA as America’s #1 Medicaid health plan. Additionally, FCHP is ranked #15 for Medicare (out of 405 plans) and #34 for commercial (out of 484 plans).
  • 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 for its 2014 Medicare Advantage and Medicare Part D Star Ratings program.  

2012

  • Summit ElderCare is the fifth largest PACE in the country.
  • FCHP launches a tiered product, Tiered Choice, in western Mass. and central Mass.
  • FCHP, in partnership with Steward Health Care, launches FCHP Steward Community Care, a limited network product. The product is selected to be the primary offering through the Retailers Association of Massachusetts’ new group purchasing cooperative.
  • 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.
  • For the fifth time in six years, FCHP is ranked by NCQA as America’s #1 Medicaid health plan. Additionally, FCHP is ranked #8 for Medicare (out of 395 plans) and #33 for commercial (out of 474 plans).
  • 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 for its 2013 Medicare Advantage and Medicare Part D Star Ratings program.

2011

  • FCHP launches its new Advantage plans with UMass Memorial Health Care and the City of Worcester. Advantage plans are a unique, two-tiered product that focuses on a community’s local providers to deliver care and offers members lower copayments at the point of service.
  • FCHP announces the expansion of NaviCare to MetroWest, Middlesex County and western Mass.
  • For the fourth time in five years, FCHP is ranked by NCQA as America’s #1 Medicaid health plan. Additionally, FCHP is ranked #12 for Medicare (out of 341 plans) and #13 for commercial (out of 390 plans).
  • FCHP is selected by Inova Health Systems, the largest not-for-profit hospital system in northern Virginia, to provide administrative services for its new Program of All-inclusive Care for the Elderly, called InovaCares for Seniors.
  • 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 for its 2012 Medicare Advantage and Medicare Part D Star Ratings program.

2010

  • Summit ElderCare becomes the largest Program of All-inclusive Care for the Elderly in New England.
  • FCHP introduces Medicare Supplement health insurance options.
  • For the second year in a row, FCHP is the only health plan in America to achieve Top 10 Honor Roll status in all product categories according to a ranking by NCQA. Additionally, FCHP is the #1 Medicaid plan in the country and the highest-ranked Medicare plan in Massachusetts.

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 becomes the first Massachusetts health plan to offer health insurance products through eHealthInsurance.com.
  • The Family Fun 2009 program is introduced to FCHP members, offering cost-saving discounts at family-oriented attractions throughout our service area.
  • Pioneer Institute honors FCHP with Special Recognition in its 2009 Better Government Competition for demonstrating how to reduce cost trends while maintaining quality through the combined use of a limited network and a defined contribution strategy.
  • FCHP introduces NaviCaresm HMO, our Senior Care Options/Medicare Advantage Special Needs Program program.
  • FCHP is the only plan in America to achieve Honor Roll status in all product categories and is the highest-ranked Medicare health plan in Massachusetts, according to a joint ranking by U.S.News & World Report and the NCQA.

2008

  • FCHP and VNA Care Network & Hospice announce a joint venture to acquire Worcester-based Home Staff, a privately held, home supportive services agency with offices throughout Massachusetts that provides a variety of in-home services.
  • FCHP named the #1 health plan in America for Medicaid by the U.S.News & World Report and the NCQA.
  • FCHP is named a “Champion in Health Care” by the Boston Business Journal.
  • FCHP launches childhood obesity initiative, “Commit to Be Fit,” in schools across Massachusetts.
  • Summit ElderCare opens a second facility in Charlton, Mass., and a second facility in Worcester, on Grafton Street.

2007

  • Summit ElderCare expansion continues with the opening of a new site in Leominster.
  • FCHP named the #1 health plan in America for Medicare and Medicaid by U.S.News & World Report and the NCQA*.  

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.

From 2001 to present

  • FCHP receives consistent rankings by NCQA* as one of the nation’s top health plans.  

From 2000 to 2015

  • FCHP receives an accreditation status of “Excellent” for both its commercial and Medicare Advantage plans from the National Committee for Quality Assurance (NCQA)*. In 2006, FCHP becomes the only health plan in Massachusetts to receive an accreditation status of “Excellent” from the NCQA for all three product categories (commercial, Medicare and Medicaid) and continues to maintain this accreditation status.

1999

  • FCHP is rated the top HMO in America by Newsweek (November 8, 1999). The ranking was based on 28 measures of quality.

1998

  • FCHP is named the #1 HMO in the country by U.S.News & World Report.
  • FCHP is one of only four health plans in the country to receive an “A” in patient satisfaction by Newsweek.

1997

  • Fallon Community Health Plan is rated one of the top 10 HMOs in the country by U.S.News & World Report.
  • FCHP is rated fourth best HMO in the country by Newsweek.
  • FCHP receives second highest rating in overall satisfaction in USA TODAY® study of 200 HMOs nationwide, based on data compiled by the NCQA* (USA TODAY, October 2 and 8).
  • FCHP receives best overall rating in study conducted by Massachusetts Healthcare Purchasers Group.
  • FCHP has lowest Medicare beneficiary disenrollment rate in the country, according to Families USA (The Wall Street Journal, ® December 5).

1996

  • FCHP named #1 HMO in the country by U.S.News & World Report.
  • FCHP is one of only four HMOs in the country to receive overall excellent rating by Newsweek.

1995

  • Bloomberg Personal names FCHP one of the top three HMOs in the country.

1994

  • FCHP begins developing Elder Service Plan, a Program of All-inclusive Care for the Elderly (PACE). In 2005, Elder Service Plan was renamed Summit ElderCare®.
  • FCHP is first HMO in state to receive accreditation from National Committee for Quality Assurance (NCQA)*.

1991

  • FCHP recognized as one of the nation’s top 10 HMOs (HMO Buyers Guide).

1990

    Expansion southeast and southwest Massachusetts

1989

  • Largest HMO in central Massachusetts
  • Fourth largest HMO in Massachusetts

1986

  • FCHP covers Worcester’s first heart transplant patient.

1985

  • Expansion into northern Worcester County and Middlesex County

1980

  • FCHP becomes one of the first HMOs in the country to receive a special contract for Medicare recipients through the U.S. Health Care Financing Administration.

1979

  • FCHP receives first state contract to cover Medicaid recipients.

1978

  • FCHP becomes 75th qualified HMO in U.S. and the first federally qualified HMO in central Massachusetts.

1977

  • Fallon Community Health Plan is founded.

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

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