Wellforce and its provider organizations in partnership with Fallon Health, will offer a new managed care option—Wellforce Care Plan—for MassHealth members.
The creation of Wellforce Care Plan 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 being a patient of certain primary care providers (PCP) at Lowell Community Health Center, New England Quality Care Alliance, Tufts Medical Center, Hallmark Health, and Circle Health (Lowell PHO) will be enrolled in Wellforce Care Plan. MassHealth is a state-administered Medicaid program—funded by the state and federal governments—that provides health care 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 & 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 partner with the many outstanding providers that make up Wellforce to provide high-quality, highly coordinated care,” he added.
A key component of ACOs like Wellforce Care Plan 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.
“When Tufts Medical Center, Circle Health and Hallmark Health joined together as Wellforce, we made a commitment to helping the state lower health care costs and to enhancing the services and care we provide in our communities. The Wellforce Care Plan furthers that mission. I know our patients will benefit greatly from this partnership with Fallon Health and the Commonwealth,” said Norm Deschene, CEO, Wellforce.
To enroll in Wellforce Care Plan, individuals must live in the Wellforce Care Plan service area, which includes the Merrimack Valley, the North Shore, and parts of Boston and the South Shore. More information about Wellforce Care Plan will be available in the fall at fallonhealth.org/wellforce.