The leader of Worcester-based Fallon Health says the insurer is not looking to downsize as it’s poised to be acquired by Mass General Brigham Health Plan.
“We’re coming together to grow, not to shrink,” Fallon Health CEO Manny Lopes told the News Service when asked about job protections for more than 1,000 workers based in central Massachusetts.
Fallon spokesperson Melissa Randall said there will be “no immediate impact to employees.”
Fallon and MGB announced their intent to join the plans on Jan. 8, saying there would be “no immediate changes for members.” Fallon said it had been working to find a long-term partner to ensure members “continue to receive the care and support they need now and in the years ahead.” MGB Health Plan is based in Somerville.
Affordability issues are affecting health insurers, which are struggling to rein in costs. At a forum last January, Blue Cross Blue Shield of Massachusetts CEO Sarah Iselin cited costly medications like GLP-1 drugs and “higher utilization increases across the board.” Lopes warned payers and providers were at a “crisis point.”
Fallon stopped offering commercial health coverage in 2021, as the organization pivoted to members enrolled in Medicaid and Medicare programs. The insurer is one of Worcester’s largest private employers and is seen as an “innovative health care incubator,” said Worcester Regional Chamber of Commerce CEO Tim Murray.
Fallon’s leaders have historically been enmeshed in the city’s civic and philanthropic fabric, Murray said. The former lieutenant governor pointed out the insurer is also an anchor tenant in downtown Worcester, and that any relocations to Greater Boston could affect the city’s office vacancy rate and tax base.
“I know this is a decision that the leadership and the board didn’t come to lightly, but you know, there’s a lot of pressures in the health care space,” Murray said of Fallon. “As the negotiations continue with MGB – because they’re not finalized — it’s their intent that hopefully some of these things can be addressed and worked out, or assurances can be made. I think they hear what a lot of the concerns are in the community, and hopefully with the MGB leadership, we’ll be able to address some of those.”
Lopes, asked whether Fallon would continue to occupy buildings in Worcester and central Massachusetts after the acquisition, said, “It’s our home.”
“We’re early in the process, but the goal is to keep services within Worcester that we’re operating today and continue Fallon’s mission and tradition,” said Lopes, who is also on the board of the Worcester chamber.
Lora Pellegrini, CEO of the Massachusetts Association of Health Plans, declined to comment on the deal.
Fallon and MGB have note filed documents with the Division of Insurance, which must review and approve the transaction. The insurance commissioner must decide within 30 days after a public hearing on whether to approve the deal.
State law outlines situations in which a deal should not be approved, including if would “substantially” reduce insurance competition or create a monopoly, if the financial condition of the acquiring entity “might jeopardize the financial stability of the insurer,” or if the acquisition is “likely to be hazardous or prejudicial to the insurance buying public.”
The Health Policy Commission must also evaluate the proposed acquisition, spokesperson Mickey O’Neill said.
As Fallon and MGB hash out the deal, Murray said he wants to see assurances that Fallon’s presence and jobs remain “here in Worcester and central Mass., as opposed to being shipped to Boston or Somerville.”
Fallon in November opened its Summit ElderCare program in Dartmouth, marking the first Program of All-Inclusive Care for the Elderly to be made available in southeastern Massachusetts. The program, administered by MassHealth and Medicare, offers medical, social, recreational and wellness services. Gov. Maura Healey was on hand to celebrate the new location.
Fallon counted about 140,310 enrollees as of March 2025, according to the Center for Health Information and Analysis. MGB Health Plan had about 382,240 members.
“Fallon’s enrollment has dropped steadily from 2020, while MGB’s membership has grown during that time,” the Massachusetts Health and Hospital Association said last week. “Both plans suffered negative operating margins and negative profit margins in the past year.”
Alison Kuznitz is a reporter for State House News Service and State Affairs Pro Massachusetts. Reach her at akuznitz@stateaffairs.com.
