Collective Medical and Fallon Health Announce Partnership to Support Better Transitions of Care for High Risk Members

Partnership will also address social determinants of health for members across Massachusetts

SALT LAKE CITY--(BUSINESS WIRE)--Collective Medical, delivering the leading ADT-based network for real-time care collaboration, today announced a partnership with Fallon Health, a nationally recognized not-for-profit health care services organization. The partnership will help Fallon Health identify and support high-risk and vulnerable members, manage transitions of care and address social determinants of health across Massachusetts.

The Dartmouth Institute for Health Policy and Clinical Practice estimates that $700 billion—or 30 percent—of all Medicare clinical spending is potentially avoidable. The lack of care coordination and subsequent gaps in care are responsible for $25 to 45 billion of this sum in wasteful spending. With Collective, Fallon Health can better identify members who are in need of additional or more personalized support—like those struggling with social determinants of health—in real time and push that information to downstream providers—allowing for seamless coordination between health plans and the broader care team.

Fallon Health collaborates with care providers, hospitals and regional and national coalitions to improve health care delivery and minimize medical errors. Fallon’s continued commitment to deliver high-quality health care and exceptional service has earned Fallon consistent rankings from the National Committee for Quality Assurance as one of the nation’s highest-rated health plans.

“Collective Medical’s solutions will help us identify high risk individuals earlier and coordinate care for patients more effectively than ever before,” said Carolyn Langer, M.D., senior vice president and chief medical officer for Fallon Health. “Having information in real time means we can better manage transitions of care for high risk members, address social determinants of health, and ensure our members receive the right care at the right time and in the right setting. The partnership between Fallon and Collective Medical will improve health outcomes, enhance value and maximize a patient-centered model of care that puts members first.”

In 2019, Collective received a five out of five star rating by the Medicaid Black Book as a vendor partner for Medicaid health plans. Collective is partnered with every national health plan and serves payers across all lines of business including Medicaid, Medicare Advantage, Administrative Services and commercial. Health plans work with Collective to identify and manage complex, vulnerable patients and to support these members identified with risking risk factors.

In an analysis of data from the Collective Medical network, a review of Medicaid health plans that have implemented and used Collective over a one-year period shows a 2.3 to 6.6 percent reduction in total ED encounters with a total estimated savings of $6.1 million. These savings include only directly avoided ED visits and exclude other associated impacts. Importantly, this reduction in avoidable ED utilization was made possible by care teams being able to direct their focus on—and deliver—better, more personalized care to their high-need and vulnerable patients.

“Community-based care is the bedrock of what Collective does; connecting the healthcare community to unite behind the needs of individuals is what’s truly transforming care delivery. As more health plans, post-acute facilities, hospitals, and other stakeholders collaborate, the stronger we will become,” says Chris Klomp, CEO of Collective Medical. “We’re so pleased that we can support organizations like Fallon Health who share the same goal of protecting and supporting the most vulnerable among us.”

ABOUT COLLECTIVE MEDICAL

Collective Medical is the nation’s leading ADT-based real-time care notification, activation, and collaboration platform. Proven to streamline care transitions, improve coordination, and reduce unnecessary length of stay and admissions, Collective helps improve patient outcomes and lower costs by closing communication gaps across care settings that undermine care. With a nationwide network of thousands of hospitals and health systems, primary, specialty, and post-acute clinics, health plans and ACOs, Collective integrates alongside EHRs and health information exchanges to empower decision making by highlighting essential insights and actions to take on patients a provider has already seen, is currently seeing, or should see. Collective is based in Salt Lake City. Learn more at www.collectivemedical.com.

ABOUT FALLON HEALTH

Founded in 1977, Fallon Health is a leading health care services organization that supports the diverse and changing needs of those we serve. In addition to offering innovative health insurance solutions and a variety of Medicaid and Medicare products, we excel in creating unique health care programs and services that provide coordinated, integrated care for seniors and individuals with complex health needs. Fallon has consistently ranked among the nation’s top health plans and is accredited by the National Committee for Quality Assurance for its HMO, Medicare Advantage and Medicaid products.