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May 15, 2020

Fallon Health nears operating profitability

Photo | Grant Welker Fallon Health's Summit ElderCare program at 288 Grove St. in Worcester

Fallon Health reversed a steep operating loss at the end of 2019 to come back to profitability in the first quarter of the year with a net income of $2.3 million, the Worcester insurer reported Friday.

Fallon had a slight operating loss of $800,000 in the first quarter, with investments and other income bringing it back to profitability after a bleak fourth quarter. Fallon had an operating loss of $25.5 million to end 2019, contributing most of what ended up being a $43-million loss for the year on revenue of $1.7 billion.

The first three months of 2020 brought better results.

Fallon reported $441 million in revenue for the quarter, up $37 million, or 9%, from the same period last year. Membership was down slightly: 252,545 compared to 264,342 as of March 2019.

CFO Todd Bailey said the results were in line with expectations for what the company expected for the early stages of the coronavirus pandemic. The insurer said it turned its senior care center on Grove Street in Worcester into an infirmary for coronavirus patients who are eligible Summit ElderCare participants.

Fallon has launched an initiative to help members most at risk of coronavirus, improved access to healthcare services including telehealth, and established a hotline to connect members with representatives who could answer questions about the virus and available benefits.

Watertown-based Tufts Health Plan reported a first-quarter operating loss of $43.9 million on revenue of $1.5 billion. That compares to an operating income of $20.9 million in the first quarter last year, with revenues of $1.3 billion. Membership was 1.16 million.

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