Fallon Health reports strong 2020

Photo | Grant Welker Fallon Health's Worcester headquarters

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By Grant Welker

Fallon Health had a strong 2020, the Worcester health insurer reported Monday, with an operating profit of $63 million for the year.

The year was generally a strong one for health insurers at a time when patient trends were upended by the coronavirus pandemic, including a sharp curbing of many elective health procedures and other appointments. Health claims began making a return toward normalcy in the second half of the year, CFO Todd Bailey said in a statement accompanying the company's earnings report.

Fallon brought in $1.7 billion in revenue, including $415 million in the fourth quarter. Membership dipped slightly over the year to 260,760, a drop of less than 1%.

Fourth-quarter operating income was $19.6 million, a minor drop from consecutive quarters in which that tally exceeded $20 million.

Last year was a sharp reversal of financial fortune for Fallon, the state's fourth largest commercial health insurer. Revenue was flat year-to-year, but net income was a major improvement from a $43-million operating loss in 2019.

Fallon described an eventful 2020, shifting the vast majority of its 1,200 employees to remote work and changing coverage for members, including relaxing prior authorization, covering medically necessary coronavirus testing, treatment and counseling, and waiving cost-sharing for pandemic-related telehealth services. The company opened a 24/7 infirmary for eligible Summit ElderCare patients with COVID-19.

Among other patient-focused moves, Fallon launched an improved member portal called MyFallon in December and became the state's first health plan to offer a prescription plan called Rx Savings Solutions to Medicare beneficiaries.