WORCESTER, Mass., March 27, 2023 /PRNewswire/ — Fallon Health, with strategic partner Autism Care Partners (“ACP”), is working to bring an enhanced, innovative care model to children, and families of children, on the Autism Spectrum. The new model will address access to care and diagnostic barriers, multi-specialty collaboration, and enhanced wrap-around supports. The industry-leading collaboration is underpinned by a focus on measuring quality of care and cost outcomes through a value-based construct. The partnership will support Fallon Health’s Medicaid Accountable Care Organizations (ACO).
As a pioneer in innovative programs such as Program of All-Inclusive Care for the Elderly (PACE), Fallon Health has deep experience in providing integrated, coordinated and patient-centered care delivered through a value-based system that rewards quality over quantity. Rated as among the top health plans in the country by national rating agencies, Fallon Health is unique among health plans in its commitment to individuals served by government insurance programs.
“At our core, we are about delivering superlative care to members and lifting the communities we serve by eliminating barriers to care and addressing the underlying social determinants of health,” said David Brumley M.D., SVP and Chief Medical Officer for Fallon Health. “This approach will offer a cutting-edge program that is not currently available anywhere else in the country. And we look forward to collaborating with ACP, whose record of innovation and commitment to community matches our own, to empower patients and families, and improve lives.”
As one of the largest autism and related service providers in Massachusetts, ACP is focused on ensuring “no wrong door” to individuals on the spectrum and their families by providing and coordinating ABA, diagnostic and related services across diverse care settings. With nine treatment hubs currently across the state, ACP is eyeing continued Massachusetts expansion in 2023, while also deepening its growing bench of diagnosticians, social workers, speech therapists, and occupational therapists. Additionally ACP continues to invest in its best-in-class clinical model, enhanced through The Visual Immersion System™ (VIS™), an evidence-based and pioneering Boston Children’s-developed language acquisition intervention.
“ACP’s value-based relationship with Fallon Health is an industry leading collaboration focusing on client and cost outcomes. We’re excited to bring our clinical and operating acumen to Fallon Health’s members in a manner that rewards quality of care over quantity of care. Fallon Health’s focus on innovation makes them the perfect partner to advance ACP’s mission,” said Jim Spink, CEO of ACP.
Fallon Health has long supported the “whole person” approach to care. Working with ACP, the organizations are endeavoring to take the model a step further to a “whole family” approach that also addresses the needs of parents/caregivers and neurotypical siblings. The model will enhance the collaboration between behavioral, medical, ancillary, and community-based providers, directly correlating to better outcomes for the entire family system.
The partnership will deploy an industry-first program that clinically engages families awaiting a diagnostic evaluation with a customized program fitting the family’s needs, while also providing continuity of care post-evaluation whether or not an Autism diagnosis is confirmed. Additionally, the program will substantively enhance family support & training resources for those with a confirmed diagnosis and in care, while coordinating across a family’s continuum by closely pairing ACP’s multi-disciplinary services with Fallon’s ACO health system partners’, in addition to ancillary providers on the care team. Underpinning the delivery model will be a value-based arrangement defined by a set of measures spanning in impact from access to care, parent engagement, and clinical / quality of life outcomes.
Fallon and ACP have met with leaders at MassHealth to share specifics of the planned collaboration. Emily Bailey, Chief of Behavioral Health at MassHealth, shared, “MassHealth is supportive of innovative models that aim to improve access to care, prioritize quality and outcomes, and enhance supportive resources to families of children on the Autism Spectrum. Fallon and ACP’s partnership is an example of innovating along these tenets and aligns with MassHealth’s ACO redesign, to differentially support individuals with special needs in a family-centered manner.”
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 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. Learn more at fallonhealth.org or follow us on Facebook, Twitter and LinkedIn.
About Autism Care Partners
Founded in 1992, Autism Care Partners has become a recognized leader in the delivery of comprehensive behavioral therapy to individuals on the autism spectrum. ACP provides diagnostic evaluations, early intervention services, ABA, speech therapy, occupational therapy, and social work services to individuals on the autism spectrum, and their families, through their multi-state network of center, telehealth and home-based practices.
Contact:
Name: Melissa Randall
Title: Director, Corporate Communications
Company: Fallon Health
Phone: 800.333.2535
E-mail: [email protected]
Website: www.fallonhealth.org
Name: Nick James
Title: Chief Development Officer
Company: Autism Care Partners
Phone: 646.666.3088
E-mail: [email protected]
Website: autismcarepartners.com
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SOURCE Fallon Health & Autism Care Partners
