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July 22, 2020

Fallon joins with Utah firm to care for high-risk patients

Photo | Grant Welker Fallon's Worcester headquarters

Worcester insurer Fallon Health has joined in a partnership with a Utah-based health technology company to identify and support high-risk residents across Massachusetts.

The technology firm, Collective Medical, which announced the partnership Monday, will help Fallon identify those with worse so-called social determinants of health: conditions including socioeconomic status, employment, education and access to health care. Collective Medical says it works with health plans nationally, including for Medicaid and Medicare, to identify and manage complex and vulnerable patients.

Fallon, a nonprofit with more than 250,000 members, will use the partnership to be able to coordinate care for patients more effectively, Dr. Carolyn Langer, Fallon's chief medical officer and senior vice president, said in a statement. 

A better coordination of care is critical to addressing health needs and keeping costs manageable, Collective Medical said. Roughly 30%, or $700 billion, of Medicare clinical spending is potentially avoidable, it said, citing Dartmouth Institute for Health Policy and Clinical Practice estimates. A lack of care coordination and subsequent gaps in care are responsible for an estimated $25 billion to $45 billion of that amount, the firm said.

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1 Comments

Anonymous
July 26, 2020
Pretty awesome. They lay off 17 loyal, longstanding employees (and tell them it was because "lost" nearly $70M on their abysmal ACO product), then turn around and seemingly have no problem paying another consultant millions for services they easily could do internally. This company is going to eat itself from the inside out. Very possible it's belly-up by 10/1.
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