Fallon Health Earns NCQA's Highest Medicaid Health Plan Rating
The only Massachusetts health plan and 1 of 4 nationwide to receive a 5-Star rating
WORCESTER, Mass. September 18, 2026 – Fallon Community Health Plan, also known as Fallon Health, is a health plan accredited by the National Committee for Quality Assurance (NCQA) that has earned 5 out of 5 Stars in NCQA’s Health Plan Ratings 2026: Medicaid. Five stars is the highest rating awarded by the NCQA. Among approximately 280 Medicaid health plans evaluated nationwide, Fallon Health is the only Massachusetts health plan and 1 of only 4 in the country to be rated 5 Stars.
“Our teams deserve tremendous credit for this achievement,” said Manny Lopes, President and CEO of Fallon Health. “This recognition reflects years of collaboration among provider partners, community organizations, and Fallon Health employees working together to deliver high-quality care and a better experience for the members we serve."
The rating reflects performances across measures related to preventive care, chronic condition management, member experience, and health outcomes. It recognizes the work Fallon Health does alongside provider organizations and community partners across Massachusetts to help members access care, navigate complex health needs, and receive coordinated support.
Fallon Health's 5-Star rating builds on a longstanding record of quality performance. Fallon Health has consistently ranked among the nation's highest-rated Medicaid health plans. The 2026 rating marks the organization's first NCQA 5-Star designation.
Fallon Health's focus on quality and measurable outcomes is also reflected in its NCQA Health Outcomes Accreditation for 2023-2027. As an early adopter of the accreditation, Fallon Health has demonstrated its commitment to improving health outcomes and delivering care that is inclusive, respectful, and responsive to the diverse needs of its members.
Fallon Health contact:
Melissa Randall
Director, Corporate Communications
Fallon Health
508-368-9345
melissa.randall@fallonhealth.org
About Fallon Health
Fallon Health is a company that cares. We prioritize our members—always—making sure they get the care they need and deserve. Founded in 1977 in Worcester, Massachusetts, Fallon Health delivers equitable, high-quality coordinated care and is continually rated among the nation’s top health plans for member experience, service, and clinical quality. Today, guided by our mission of improving health and inspiring hope, we strive to be the leading provider of government-sponsored health insurance programs—including Medicare, Medicaid, and PACE (Program of All-Inclusive Care for the Elderly)— in the region.
About NCQA
The National Committee for Quality Assurance (NCQA) is a private, nonprofit organization dedicated to improving health care quality. NCQA accredits and certifies a wide range of health care organizations and recognizes clinicians in key clinical areas. NCQA's HEDIS® is the most widely used performance measurement tool in health care. NCQA's website (ncqa.org) contains information to help consumers, employers, and others make informed health care choices.