Fallon Community Health Plan Inc
Public records show a registered, tax-exempt organization in good standing.
What it says it does
TO BE THE LEADER IN PROVIDING EXCEPTIONAL COORDINATED CARE AND COVERAGE THAT MEETS THE UNIQUE, DIVERSE AND CHANGING NEEDS OF OUR MEMBERS.
- Income
- $1.8 billion
- Spending
- $1.9 billion
- Spent on programs
- 98%
- Reserves
- 1.1 months of spending
- Largest source of income
- fees for its services, 99%
- Employees
- 1,382
- Volunteers
- 0
- Highest pay
- $746,675, see schedule o for title
Source: Form 990 for the year ending December 31, 2024, filed with the Internal Revenue Service. Rating method 2026.2. How we rate
Financial health
Fair: 53 out of 100. Higher than 38% of charities in its peer group (health care, over $100m).
Reserves
10 of 35Spendable reserves would cover 1.1 months of spending.
Debt
5 of 20It owes 72% of what it owns.
Living within its means
8 of 15Spending exceeded income by 1% of income.
Income trend
15 of 15Income rose 5% on the year before.
Spending floor
15 of 1597% of spending went to programs.
Source: Form 990 for the year ending December 31, 2024, filed with the Internal Revenue Service. Rating method 2026.2. How we rate
Governance
Strong: 100 out of 100. Higher than 53% of charities in its peer group (health care, over $100m).
Independent board
25 of 2510 of 11 voting board members are independent.
Conflict of interest policy
15 of 15Has a written conflict of interest policy.
Whistleblower policy
8 of 8Has a written whistleblower policy.
Record keeping policy
7 of 7Has a written policy on keeping and destroying records.
Board minutes
5 of 5Keeps minutes of board meetings.
Board sees the tax return
10 of 10Gave the board a copy of this return before filing it.
Pay set independently
5 of 5Sets its chief executive's pay through independent review and comparison.
Independent check of accounts
15 of 15Its accounts were audited by an independent accountant.
No reported misuse
10 of 10Reports no diversion of assets, excess benefits or loans to insiders.
Source: Form 990 for the year ending December 31, 2024, filed with the Internal Revenue Service. Rating method 2026.2. How we rate
Impact evidence
Describes programs. Its tax return describes what it does but we have found no measurable results in it.
Programs described in its return (2)
- $1.7 billion spent. GOVERNMENT PROGRAMS FROM ITS VERY START IN 1977, FALLON HEALTH HAS ALWAYS BEEN COMMITTED TO SERVING THE HEALTH CARE NEEDS OF INDIVIDUALS ENROLLED IN MEDICARE AND MEDICAID PROGRAMS. IT HAS WORKED TO EXPAND THOSE OFFERINGS OVER THE YEARS, ANNOUNCING IN 2021 THAT IT WOULD PRIMARILY FOCUS ITS RESOURCES ON GOVERNMENT-SPONSORED HEALTH INSURANCE PROGRAMS. LISTED BELOW IS THE COMPLETE LIST OF THE GOVERNMENT-SPONSORED PROGRAMS FALLON HEALTH OFFERED IN 2024 IN MASSACHUSETTS. . MEDICARE ADVANTAGE . MASSHEALTH ACCOUNTABLE CARE ORGANIZATION PARTNERSHIP PLANS . MEDICARE ADVANTAGE SPECIAL NEEDS PLAN AND SENIOR CARE OPTIONS . PROGRAM OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE) . LIMITED-NETWORK PLANS VIA THE HEALTH CONNECTOR THESE PROGRAMS ENABLE FALLON HEALTH TO SERVE MEMBERS OF ALL AGES, AT ALL INCOME LEVELS AND WITH ALL TYPES OF HEALTH NEEDS. THERE ARE SEVERAL NOTABLE FACTS WHEN IT COMES TO FALLON HEALTH'S HISTORY IN GOVERNMENT PROGRAMS: . IN 1979, FALLON HEALTH RECEIVED THE FIRST CONTRACT IN MASSACHUSETTS TO COVER MEDICAID BENEFICIARIES. . IN 1980, FALLON HEALTH WAS THE FIRST HEALTH PLAN IN THE COUNTRY TO OFFER A MEDICARE ADVANTAGE PLAN. . IN 1995, FALLON HEALTH STARTED ITS PACE PROGRAM IN MASSACHUSETTS, KNOWN TODAY AS SUMMIT ELDERCARE. IT IS THE LARGEST PACE PROGRAM IN NEW ENGLAND AND INCLUDES FIVE PACE CENTERS IN MASSACHUSETTS. . IN 2010, FALLON HEALTH LAUNCHED NAVICARE, A MEDICARE ADVANTAGE SPECIAL NEEDS PLAN AND SENIOR CARE OPTIONS PROGRAM IN MASSACHUSETTS. . IN 2017, FALLON HEALTH WAS SELECTED TO PARTICIPATE IN THE REDESIGN OF MASSACHUSETTS' MEDICAID PROGRAM AND FORMED THREE MASSHEALTH ACCOUNTABLE CARE ORGANIZATION PARTNERSHIP PLANS. . IN 2021, FALLON HEALTH ANNOUNCED A PRIMARY FOCUS ON SUPPORTING THE HEALTH CARE NEEDS OF INDIVIDUALS ENROLLED IN GOVERNMENT-SPONSORED HEALTH INSURANCE PROGRAMS, RESULTING IN THE NEAR COMPLETE WITHDRAWAL FROM THE COMMERCIAL MARKET BY THE END OF AUGUST 2022. FALLON HEALTH CONTINUES TO SELL ITS COMMUNITY CARE PRODUCT ON THE HEALTH CONNECTOR. THE PRODUCT IS AVAILABLE TO INDIVIDUALS AND SMALL GROUPS IN THE FOLLOWING MASSACHUSETTS' COUNTIES: BERKSHIRE, BRISTOL, HAMPDEN, MIDDLESEX, NORFOLK, PLYMOUTH, SUFFOLK, MIDDLESEX AND WORCESTER. . IN 2022, FALLON HEALTH WAS SELECTED TO CONTINUE ITS PARTICIPATION IN THE MASSHEALTH ACCOUNTABLE CARE PARTNERSHIP PROGRAM, ADDING A NEW ACO IN PARTNERSHIP WITH ATRIUS HEALTH. . IN 2024, FALLON HEALTH WAS SELECTED BY EOHHS TO RECONTRACT WITH THE STATE AND CONTINUE OPERATING NAVICARE, ITS SENIOR CARE OPTIONS PROGRAM.
- $116.8 million spent. COMMUNITY GIVING FALLON HEALTH'S MISSION, IMPROVING HEALTH AND INSPIRING HOPE, ISN'T JUST A GUIDING PRINCIPLE BUT ALSO THE FOUNDATION OF OUR COMMUNITY BENEFITS PROGRAM AND STRATEGY. REINFORCED BY A NEARLY 50-YEAR COMMITMENT TO CARING FOR THOSE WHO NEED US MOST, WE'RE DEDICATED TO ADDRESSING THE NEEDS OF DISADVANTAGED POPULATIONS WHO LIVE IN THE COMMUNITIES WE SERVE. IN PURSUIT OF ITS COMMUNITY BENEFITS MISSION, FALLON HEALTH WORKS COOPERATIVELY AND COLLABORATIVELY WITH HEALTH CARE AND COMMUNITY-BASED ORGANIZATIONS, AS WELL AS STATE AND FEDERAL AGENCIES TO CREATE INNOVATIVE AND EQUITABLE HEALTH CARE SOLUTIONS, SEEK HEALTHY OUTCOMES, AND IMPROVE ACCESS TO HEALTH CARE SERVICES. OUR STRATEGY IS DESIGNED WITH 5 SPECIFIC GOALS IN MIND INCLUDING: 1.IMPROVING HEALTH STATUS. DEVELOP, IMPLEMENT, AND SUPPORT PROGRAMS THAT IMPROVE THE HEALTH STATUS OF UNDERSERVED OR AT-RISK POPULATIONS WITHIN OUR SERVICE AREA AS DETERMINED BY THE NEEDS OF THE COMMUNITIES WE SERVE. 2.HEALTH EDUCATION. CONTINUE OUR ROLE AS A HEALTH EDUCATOR BY PROVIDING RESOURCES, HOSTING HEALTH AND INFORMATION PROGRAMS, AND BY BRINGING GENERAL INFORMATION TO THE PUBLIC THROUGH SPEAKING ENGAGEMENTS, PROGRAMS, AND THE USE OF OUR COMMUNICATION PLATFORMS. 3.COMMUNITY ENGAGEMENT. CONVENE KEY COMMUNITY STAKEHOLDERS, PROVIDERS, COMMUNITY-BASED ORGANIZATIONS, AND INDIVIDUALS TO DISCUSS ESCALATING HEALTH ISSUES THAT HAVE A SIGNIFICANT EFFECT ON THE COMMUNITY'S POSITIVE HEALTH OUTCOMES, ACCESS TO QUALITY CARE, AND OVERALL COST OF CARE. 4.PARTNERSHIP DEVELOPMENT. DEVELOP PARTNERSHIPS THAT ALLOW US TO SUPPORT AND/OR IMPLEMENT COMMUNITY HEALTH IMPROVEMENT PLANS AND PROGRAMS THAT ARE IDENTIFIED THROUGH LOCAL COMMUNITY HEALTH ASSESSMENTS AND ADDRESS THE BARRIERS THAT IMPACT POSITIVE HEALTH OUTCOMES. 5.CULTURALLY COMPETENT CARE. CONTINUE TO FIND WAYS TO DELIVER OR PROVIDE ACCESS TO CULTURALLY COMPETENT, HIGH-QUALITY, LOW-COST HEALTH CARE COVERAGE TO PEOPLE OF ANY AGE, RACE, ETHNICITY, RELIGION, ABILITY, SEXUAL ORIENTATION, GENDER IDENTITY, HEALTH STATUS AND INCOME LEVEL. FALLON HEALTH IS COMMITTED TO MAKING RESOURCES AVAILABLE TO COMMUNITY ORGANIZATIONS AS APPROPRIATE IN PURSUIT OF THESE GOALS. TO DETERMINE OUR COMMUNITY BENEFITS PROGRAM FUNDING PRIORITIES AND TARGETED POPULATIONS, WE USE FINDINGS FROM THE COMMUNITY HEALTH NEEDS ASSESSMENT IN WHICH WE DIRECTLY PARTICIPATE- THE GREATER WORCESTER CHNA- AS WELL AS THOSE CONDUCTED IN KEY GEOGRAPHIES ACROSS THE COMMONWEALTH BY ORGANIZATIONS INCLUDING BAYSTATE MEDICAL CENTER, THE GREATER LOWELL HEALTH ALLIANCE, LAWRENCE GENERAL HOSPITAL, BERKSHIRE HEALTH SYSTEMS, AND SOUTH SHORE HEALTH. AS WE DEVELOP OUR STRATEGY, CONSIDERATION IS GIVEN TO PRIORITY AREAS IDENTIFIED IN THE ASSESSMENTS, MISSION ALIGNMENT, AND COMMUNITY VALUE INCLUDING CONTINUITY WITH PRIOR YEARS' FUNDING PRIORITIES AND THE POPULATIONS WE SERVE. BASED ON THE ABOVE CRITERIA, WE IDENTIFIED THE FOLLOWING 3 FUNDING PRIORITIES AND TARGET POPULATIONS FOR 2024 - 2026: 1.FOOD AND NUTRITION SECURITY. PRIORITY WILL BE GIVEN TO PROGRAMS THAT IMPROVE OR EXPAND ACCESS TO HEALTHY AND CULTURALLY INCLUSIVE FOOD SOURCES WITH A FOCUS ON INDIVIDUALS AND FAMILIES WITH LIMITED ECONOMIC MEANS. 2.OLDER ADULTS. PROGRAMS FOR OLDER ADULTS THAT SUPPORT HOUSING SAFETY AND STABILITY, THAT MITIGATE ISOLATION AND LONELINESS, OR THAT WORK TO ELIMINATE BARRIERS TO HEALTH CARE E.G.: TECHNOLOGY, TRANSPORTATION, AND HEALTH LITERACY. 3.EARLY INTERVENTION PROGRAMS FOR CHILDREN AND YOUTH. PRIORITY WILL BE GIVEN TO PROGRAMS THAT FOCUS ON MENTAL HEALTH, BEHAVIORAL HEALTH, AND/OR SUBSTANCE USE PREVENTION, EDUCATION, AND AWARENESS. IN 2024, FALLON HEALTH DISTRIBUTED APPROXIMATELY $1.5 MILLION TO SUPPORT ORGANIZATIONS AND PROGRAMS THAT MET THE GOALS OF ITS COMMUNITY BENEFITS PROGRAM. SUPPORT FOR OUR FUNDING PRIORITIES INCLUDED GRANTS, DIRECT EXPENSES, LEVERAGED EXPENSES, AND CONTRIBUTIONS OF STAFF AND VOLUNTEER TIMES. IN ADDITION, FALLON SUPPORTED OTHER PHILANTHROPIC INITIATIVES THROUGH CORPORATE SPONSORSHIPS. IN ADDITION TO ITS COMMUNITY BENEFITS GRANT PROGRAMS, FALLON HEALTH SUPPORTS THE COMMUNITIES IT SERVES IN THE FOLLOWING WAYS: . EMPLOYEE VOLUNTEERING - FALLON HEALTH EMPLOYEES RECEIVE UP TO 8 HOURS OF PAID WORK TIME EACH YEAR TO ENCOURAGE VOLUNTEERISM. IN 2024, OUR WORKFORCE SELF-REPORTED 5,408 HOURS OF COMMUNITY SERVICE WITH 853 SUPPORTING FALLON HEALTH DRIVEN INITIATIVES. THIS INCLUDED TAKING PART IN COMPANY-LED EFFORTS SUCH AS THE UNITED WAY DAY OF CARING, HELPING TO GET THE RON BURTON TRAINING VILLAGE READY FOR SUMMER CAMPERS, AND ORGANIZING A FOOD DRIVE AROUND THE HOLIDAYS. MANY ALSO PARTICIPATED IN A COMMUNITY SERVICE ACTIVITY OF THEIR CHOOSING. . CORPORATE SPONSORSHIPS - WE HAVE A LONG-STANDING COMMITMENT TO SUPPORT OTHER NOT-FOR-PROFIT COMMUNITY AND BUSINESS PARTNERS THAT ARE CLOSELY ALIGNED WITH OUR MISSION. . SERVING ON BOARDS AND COMMITTEES - IN 2024, FALLON HEALTH EMPLOYEES ACTIVELY SUPPORTED COMMUNITY OUTREACH BY SERVING ON VARIOUS BOARDS AND COMMITTEES, INCLUDING BOSTON HEALTHCARE FOR THE HOMELESS, BOYS AND GIRLS CLUB OF WORCESTER, YWCA OF CENTRAL MASS., CASA PROJECT, OPEN SKY COMMUNITY SERVICES, AND OTHERS. . LEADING EMPLOYEE-DRIVEN INITIATIVES - IN 2024, FALLON HEALTH EMPLOYEES PROVIDED MEALS FOR 546 FAMILIES THROUGH THE ANNUAL FEED-A-FAMILY PROGRAM, DONATING $32,760 WORTH OF FOOD TO FAMILIES IN VARIOUS COMMUNITIES. THE STRIKE OUT HUNGER CAMPAIGN, IN PARTNERSHIP WITH THE WORCESTER RED SOX, RESULTED IN A $50,000 DONATION TO THE WORCESTER COUNTY FOOD BANK. ADDITIONALLY, NEW OPPORTUNITIES WERE INTRODUCED FOR FANS TO DONATE FOOD OR MONEY AT POLAR PARK GAMES. . SUPPORTING CORPORATE DRIVEN INITIATIVES - FALLON HEALTH'S ANNUAL UNITED WAY CAMPAIGN ALIGNS WITH OUR MISSION TO SERVE THE COMMUNITY'S HEALTHCARE NEEDS. THROUGH CORPORATE GIVING AND EMPLOYEE DONATIONS, WE HELP UNDERSERVED INDIVIDUALS ACCESS ESSENTIAL RESOURCES LIKE FOOD, SHELTER, TRANSPORTATION, AND JOB OPPORTUNITIES. EMPLOYEES CAN PARTICIPATE IN FUNDRAISING ACTIVITIES AND MAKE PERSONAL DONATIONS VIA PAYROLL DED
Source: Form 990 for the year ending December 31, 2024, filed with the Internal Revenue Service. Rating method 2026.2. How we rate
Legitimacy checks
Is it registered with the IRS? Passed.
Listed in the IRS master file of tax-exempt organizations as a 501(c)(3) charitable organization.
Source: Exempt Organizations Business Master File, Internal Revenue Service, file dated September 7, 2026.
Has the IRS revoked its tax-exempt status? Passed.
Not on the IRS automatic revocation list.
Source: Automatic revocation of exemption list, Internal Revenue Service, file dated September 30, 2026.
Are donations tax-deductible? Passed.
On the IRS list of organizations eligible to receive tax-deductible contributions.
Source: Publication 78 data: organizations eligible for tax-deductible contributions, Internal Revenue Service, file dated September 10, 2026.
Is it keeping up with its IRS filings? Passed.
Most recent return on file covers the year ending December 2024.
Source: Exempt Organizations Business Master File, Internal Revenue Service, file dated September 7, 2026.
How long has it been tax-exempt? Passed.
Recognized by the IRS since March 1976.
Source: Exempt Organizations Business Master File, Internal Revenue Service, file dated September 7, 2026.
Is it in good standing with state regulators? Passed.
Not on California's list of charities barred from soliciting. Other states are not yet checked.
Source: May Not Operate or Solicit for Charitable Purposes list, California Attorney General, Registry of Charities and Fundraisers, file dated October 7, 2026.
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