Hughes to retire as Fallon CEO

W. Patrick Hughes

Richard Burke

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By Rick Saia

W. Patrick Hughes, the president and CEO of Fallon Health, will retire Nov. 1, the health insurer’s board of directors announced Tuesday.

Hughes, 68, who has led Fallon for five years, will be replaced by Richard Burke, the organization’s president of senior care services and government programs, as interim CEO, according to a statement from Fallon. The company said the board will begin to discuss plans to find a permanent successor when it meets next.

Tuesday’s statement from Fallon’s board commended Hughes for his leadership since 2010.

“Under Pat’s leadership, Fallon achieved considerable success in many areas — membership, service, quality, employee engagement, brand reputation, and product and network expansion — at a time of great change and disruption in the industry and market,” said David W. Hillis, Fallon’s board chairman. “We thank him for his contributions and congratulate him on his retirement.”

The change in executive leadership comes as Fallon is cutting 45 jobs. Those cuts, tied to the shutdown of its Total Care program, will take effect Sept. 30, according to Colleen Quinn, a spokeswoman for the Massachusetts Executive Office of Labor and Workforce Development. The agency had received official notice from Fallon in July that it would cut the positions.

In June, Fallon announced it would end Total Care, which has served members eligible for both Medicaid and Medicare since October 2013. Through Total Care, Fallon is one of three Bay State insurers that were participating in an insurance program offered in collaboration with MassHealth, the state's Medicaid program, and Medicare. The decision to end the program for some 5,400 enrollees was made because it was "not economically sustainable," the company said. When Total Care was launched, Fallon officials expected between 8,000 and 10,000 enrollees.

Joined Fallon in 2007

Hughes joined Fallon in 2007 as senior vice president and chief marketing and sales officer, responsible for implementing and executing the organization’s marketing and sales strategy in New England. In that same year, he was named president of Fallon’s Health Plan Operations Division, which encompassed several areas, including customer service, sales, marketing, product development, care and utilization management and information technology. Before coming to Fallon, Hughes led a consulting and brokerage firm he founded in New Hampshire. Prior to that, he was senior vice president of sales, marketing and product development for Blue Cross Blue Shield of Massachusetts from 1994 to 2000.

Hughes is a former professional football player, having played linebacker for the New York Giants and New Orleans Saints. He played college football at Boston University.

Burke, who joined Fallon in 1998, has held senior management roles overseeing government and regulatory affairs, corporate compliance and a variety of operational departments. In his current role, Burke is responsible for overseeing Fallon’s government product lines serving both aging populations and high-risk populations of all ages. These include Fallon Senior Plan, Summit ElderCare, NaviCare, and MassHealth. He also oversees all regulatory, privacy and compliance matters for the organization.

Burke has served on several local boards including the Central Massachusetts Agency on Aging, Fitchburg State University, the Worcester Regional Research Bureau and the Worcester Economic Club. He currently sits on the board of the Worcester Regional Chamber of Commerce.

“In Richard, we see a leader with a strong commitment to both Fallon and to the communities it serves,” Hillis added in the Fallon statement. “We’re confident in his demonstrated ability to lead the organization through this time of transition.”