Fallon Health

Fallon Health

Not-for-profit health plan for seniors.

Overview

Fallon Health is a not-for-profit health care organization that provides coordinated, integrated care for older adults and people with complex health needs. It offers Medicare Advantage, SCO, MassHealth ACO Partnership Plans, and Programs of All-Inclusive Care for the Elderly (PACE) in Massachusetts and New York, including Summit ElderCare and Fallon Health Weinberg–PACE. Its PACE programs deliver all-inclusive medical and social services as an alternative to nursing homes, funded through a mix of Medicare, Medicaid, and private coverage. The company differentiates itself by a not-for-profit mission, strong community engagement, and a focus on vulnerable populations, with top ratings for member experience and clinical quality; its goal is to improve health and quality of life while promoting equitable care.

About Fallon Health

Simplify's Rating
Why Fallon Health is rated
C-
Rated C on Competitive Edge
Rated C on Growth Potential
Rated D+ on Differentiation

Industries

Financial Services

Healthcare

Company Size

501-1,000

Company Stage

N/A

Total Funding

N/A

Headquarters

Worcester, Massachusetts

Founded

1977

People at Fallon Health

People at Fallon Health who can refer or advise you

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Simplify's Take

What believers are saying

  • Expanded Community Care service to Bristol and Plymouth counties in January 2025.
  • Achieved 0.00% involuntary disenrollment rate in calendar year 2024.
  • Named a 2024 Emerging Leader in Healthcare and building new PACE Center.

What critics are saying

  • CMS risk overstatement of $408,557 discovered in 2022 risks high penalty.
  • Mandatory Carelon partnership erodes margins and reduces cost control flexibility.
  • 2023 Mass.gov financial deficiencies risk high regulatory penalty in 9-15 months.

What makes Fallon Health unique

  • Fallon Health is a nationally not-for-profit healthcare organization in Worcester, MA.
  • Company earned NCQA Health Equity Accreditation in December 2024.
  • Fallon has a 4.5-star NCQA Medicaid rating for seven consecutive years.

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Benefits

Health Insurance

Paid Time Off

Paid Holidays

Vision Insurance

Life Insurance

Flexible Work Hours

Company News

Fallon Community Health Plan
Mar 3rd, 2022
Fallon Community Health Plan, Inc. hired Katie Acker as Health Equity Program Manager on Mar 3rd 22'.

Fallon Health, a nationally recognized not-for-profit health care services organization, today announced that Katie Acker, MPH, has been named to the newly created role of Health Equity Program Manager.

Fallon Community Health Plan
Jan 11th, 2022
Fallon Community Health Plan, Inc. partnered with Worcesterschools on Jan 11th 22'.

It is with great pride that Fallon Community Health Plan, Inc. partner with the City of Worcester to provide five years of fitness at the Senior Center.”

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