As health systems brace themselves for looming cuts to Medicaid, Worcester insurer Fallon Health is set to be acquired by Somerville-based Mass General Brigham Health Plan, creating what is expected to be the third-largest insurer in Massachusetts.
As health systems brace themselves for looming cuts to Medicaid, Worcester insurer Fallon Health is set to be acquired by Somerville-based Mass General Brigham Health Plan, creating what is expected to be the third-largest insurer in Massachusetts.
“This reflects the outcome of Fallon Health’s thoughtful and intentional process to identify a long-term partner aligned with its mission and strategic vision—one that ensures members continue to receive the care and support they need now and in the years ahead,” read Fallon’s and Mass General Brigham’s joint statement on Thursday.
The healthcare systems see the union as an avenue to expand affordable access to care and boost care coordination, especially focusing on Medicare and Medicaid recipients.
There will be no immediate changes affecting Fallon Health members.
The acquisition comes five years after
Fallon dropped out of the commercial health insurance market to focus on government programs like Medicare and Medicaid and two years after Manny Lopes took over as Fallon’s president and CEO.
The deal will potentially elevate the Mass General Brigham plan to become the third-largest health insurer in Massachusetts.
Mass General Brigham is the fourth-largest insurer with 230,254 Massachusetts members as of Dec. 31, 2024, representing a 10.11% share of the Massachusetts market in the fourth quarter of 2024, according to data collected by WBJ’s Research Department. Fallon’s plan is the seventh-largest, with 127,844 Massachusetts members, representing a 5.61% share of the market.
As of Q3 2025, Mass General Brigham had 405,028 members and Fallon had 148,011, according to data provided by Fallon.
The current third-largest Massachusetts insurer is Tufts Health Public Plans, with 329,708 Massachusetts members.
EDITOR'S NOTE: This story has been updated to include the Q3 2025 membership figures for Fallon Health and Mass General Brigham Health Plan.
Mica Kanner-Mascolo is a staff writer at Worcester Business Journal, who primarily covers the healthcare, manufacturing, and higher education industries.
