Fallon Health, BHS, Community Health Programs Form ACO

WORCESTER — Berkshire Health Systems, through its physician hospital organization called the Partnership for Health in the Berkshires, and Community Health Programs, in partnership with Fallon Health, will offer a new managed-care option — Berkshire Fallon Health Collaborative (BFHC) —for MassHealth members. The creation of BFHC is part of the state’s reform of MassHealth to include accountable-care organizations (ACOs), in which physicians, hospitals, insurers, and other healthcare 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 as having a Berkshire Health Systems or a Community Health Programs primary-care provider (PCP) will be enrolled in BFHC. MassHealth is a state-administered Medicaid program — funded by the state and federal governments — that provides healthcare to eligible people who need health coverage.

“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 and CEO of Fallon Health, referring to Fallon Health’s Program of All-inclusive Care for the Elderly (PACE), Summit ElderCare, and its 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 expand our presence in this region and partner with Berkshire Health Systems and Community Health Programs to provide high-quality, highly coordinated care.”

A key component of ACOs like BFHC is the utilization of community-based health and social-service organizations to improve behavioral healthcare, put in place long-term supports, and address health-related social needs, all of which contribute to better health outcomes.

“Berkshire Health Systems and our community partners have worked to improve access and to better integrate the care we provide to our community,” said David Phelps, president and CEO of Berkshire Health Systems. “We look forward to working with Fallon Health and our community-based partners to better meet the healthcare needs of those who depend on us.”

Added Lia Spiliotes, CEO of Community Health Programs, “as Community Health Programs expand its healthcare network throughout Berkshire County, we are reaching more and more MassHealth residents. We look forward to this new model of stronger care coordination with Berkshire Health Systems and Fallon.”