Fallon Health reports third quarter financial results

Worcester, Mass., November 14, 2014 - Fallon Health today reported net income of $1.9 million on revenue of $323 million for the third quarter that ended September 30, 2014. Net income includes investment and other income of $5.8 million and an operating loss of $3.9 million. Included in these results are a $2.3 million ACA fee and $3.4 million for expensive hepatitis C treatment. For the same quarter last year, Fallon posted net income of $5.4 million on revenue of $316 million. Net income included investment and other income of $3.8 million and operating income of $1.6 million. Membership was 231,541 as of September 30, 2014, compared with 227,624 ending September 30, 2013.

“Results for the third quarter are consistent with our expectations. We remain focused on advancing our high-quality and affordable networks, expertise in complex care management and member-centric technology so that we can better meet the needs of the communities we serve,” said R. Scott Walker, Fallon Executive Vice President and Chief Financial Officer. “In recognition of the quality and innovation we offer members, Fallon maintains its top 10% NCQA* rankings among all health plans in the nation. We also continue to develop a rich portfolio of affordable products including our new innovative solution, Community Care, which focuses on the needs of the subsidized individual market.”

*NCQA is a private, non-profit 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 measure tool in health care.


Carrie Wattu

About Fallon Health
Founded in 1977, Fallon Health is a leading, non-profit health care services organization that supports the diverse and changing needs of those it serves. In addition to providing innovative health insurance solutions and a variety of Medicaid and Medicare products, Fallon excels in unique health care programs and services that coordinate care for seniors and individuals with complex health needs. Fallon has consistently ranked among the nation’s top health plans, and is the only health plan in Massachusetts to have been awarded “Excellent” Accreditation by the National Committee for Quality Assurance for its HMO, Medicare Advantage and Medicaid products.