Quality at Fallon Health

 Fallon Health aims to assure that safe, effective, patient-centered, timely, efficient and equitable clinical care and services are provided to members. To ensure the quality and safety of clinical care and service, Fallon has established Quality Programs. In order to continually improve services to members in the community, Quality Programs aligns with Fallon Health's mission, values and vision statements.

For detailed Quality Programs information:
Download Fallon Health ’s Quality Programs brochure

National accreditation

Fallon Health consistently ranks as one of the nation’s highest-rated health plans according to the National Committee for Quality Assurance (NCQA)*. Fallon Health is the only Massachusetts health plan to be accredited across all three product lines (Private, Medicare, and Medicaid).

For details:
Download Fallon Health’s Quality Programs brochure 
Visit NCQA's website

Patient safety standards

Fallon Health collaborates with providers, hospitals and regional and national coalitions to improve health care delivery and minimize medical errors.

Activities associated with patient safety include the clinical peer review activities that identify case reviews related to clinical quality and the evaluation of possible errors of commission and omission. Corrective action plans are also carried out when areas of substandard care are identified, and follow-up is required that addresses practitioner-specific components as well as system issues identified through peer review committees.

Pharmaceutical patient safety is also monitored, with procedures in place for point-of-dispensing communications to identify drug-drug interactions and classify them by severity. Screening of new drugs and technologies occurs through Fallon's Pharmacy and Therapeutics Committee and Technology Assessment Committee, with input from national guidelines and research consortia.

For details on patient safety standards: 
Download Fallon Health’s Quality Programs brochure

Hospital patient safety standards

Fallon Health voluntarily participates in the activities of The Leapfrog Group, an initiative driven by organizations who are working to initiate breakthrough improvements in the safety, quality, and affordability of healthcare for Americans.

The Leapfrog Group has developed standards in several key areas:

  • Physician staffing in intensive care units
  • The use of computers in hospitals for ordering prescriptions
  • The number of certain high-risk treatments or procedures a hospital performs each year
  • A Leapfrog Quality Index summarizing performance on the 27 National Quality Forum procedures to reduce preventable medical mistakes.

For details on hospital patient safety standards: 
Download Fallon Health's Quality Programs brochure
Visit Leapfrog's hospital standards at www.leapfroggroup.org

* NCQA is a private, non-profit organization dedicated to improving health care quality.