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August 15, 2019

Fallon reports $1.3M second-quarter profit

Photo | Grant Welker Fallon's Worcester headquarters

Fallon Health brought in $1.3 million in operating income in the second quarter, the Worcester health insurer announced Thursday.

Membership was largely flat from the previous quarter at 265,981. Membership hit an all-time high for the company of 271,369 at the end of 2018, aided by Fallon's involvement in MassHealth's accountable care organizations, which join insurers and health providers for the state's Medicaid patients. In the last five years, government programs as a percentage of Fallon's total membership have increased to 50% from 20%.

Fallon's results include $415 million in revenue for the quarter ended June 30. Net income was $3.5 million, helped in large part by investment and other income of $2.2 million.

Revenue, like membership, has fallen slightly. For the same quarter a year ago, Fallon's revenue was $422 million. Lisa Cohen, Fallon's interim CFO, said second-quarter 2019 results were consistent with expectations.

Second-quarter results from Fallon and other major health insurers comes a day after two of the state's largest, Tufts Health Plan and Harvard Pilgrim Health Care, said they plan to merge. The deal is subject to regulatory approval.

Tufts and Harvard Pilgrim have a combined 2.4 million members, split fairly evenly between them, in Massachusetts, Maine, Connecticut, New Hampshire and Rhode Island.

Boston-based Blue Cross Blue Shield of Massachusetts and Blue Cross Blue Shield of Massachusetts HMO Blue reported an operating loss of $16.5 million on revenue of $2.1 billion. Blue Cross is by far the largest health insurer in Massachusetts, with 2.8 million members.

Harvard Pilgrim Health Care, which is based in Wellesley, reported an operating income of $29 million on revenue of $756 million. Membership was just over 1.1 million, down slightly from the previous quarter.

Tufts Health Plan, which is based in Watertown, took in $25.6 million in operating income in the quarter, with revenue of $1.4 billion. Membership was just under 1.2 million.

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