Reliant Medical Group and Fallon Health today announced that the two Worcester-based companies are partnering to offer a new managed care option—Fallon 365 Care—for MassHealth members. The creation of Fallon 365 Care is part of the state’s reform of MassHealth to include Accountable Care Organizations (ACO) in which physicians, hospitals, insurers and other health care providers work together to provide integrated care with the goals of improving health outcomes and containing costs.
Effective March 1, 2018, MassHealth members identified by the Executive Office of Health & Human Services (EOHHS) as having a primary care provider (PCP) with Reliant Medical Group or Southboro Medical Group (part of Reliant Medical Group) will be enrolled in Fallon 365 Care. MassHealth is a state-administered Medicaid program, funded by the state and federal governments, which provides health care to eligible Massachusetts residents.
“With our experience providing integrated care through other government programs, Fallon Health is perfectly positioned to provide care under the ACO model,” said Richard Burke, President & CEO of Fallon Health, referring to Fallon Health’s Program of All-inclusive Care for the Elderly (PACE) – Summit ElderCare – and Senior Care Options/Special Needs Plan –Navicare. “We believe this approach will help reduce fragmented care, improve health outcomes and contain costs.”
“We’re pleased to be partnering with Reliant Medical Group, with which we have a long history of working together to provide high-quality, highly-coordinated care to the patients and members we mutually serve,” he added.
A key component of ACOs like Fallon 365 Care is the utilization of community-based health and social service organizations to improve behavioral health care, put in place long-term supports and address health-related social needs—all of which contribute to better health outcomes.
“Providing proactive, well-coordinated care has been an integral part of our care model since our inception,” observes Tarek Elsawy, MD, president & CEO. “We are anxious to collaborate through this ACO with Fallon Health and other essential caregivers in the community to meet the diverse health care needs of our patients with MassHealth.”
To enroll in Fallon 365 Care, individuals must live in the Fallon 365 Care service area, which includes many cities and towns in Middlesex and Worcester counties. More information about Fallon 365 Care will be available in the fall at 1-855-508-3390 or fallonhealth.org/365care.