Contract
H9001

Fallon Health · 2027 Star Ratings

FALLON COMMUNITY HEALTH PLAN · Local CCP

Parent: Fallon Community Health Plan, Inc.

Summary ratings

Overall
4.0
2026: 4.0±0
Part C · health plan
4.0
2026: 4.0±0
Part D · drug plan
4.0
2026: 4.0±0

2027 footprint

Members, Sep 2026
12K
2027 plans
11
Open to all ($0 premium)
11 (4)
Counties
12
Special needs plans
None
Drug coverage
Yes
MA

Domain stars

Domain20272026Change
HD1Staying Healthy: Screenings, Tests and Vaccines4.04.0±0
HD2Managing Chronic (Long Term) Conditions3.04.0−1.0
HD3Member Experience with Health Plan4.04.0±0
HD4Member Complaints and Changes in the Health Plan's Performance4.05.0−1.0
HD5Health Plan Customer Service4.03.0+1.0
DD1Drug Plan Customer Service3.04.0−1.0
DD2Member Complaints and Changes in the Drug Plan's Performance4.04.0±0
DD3Member Experience with the Drug Plan3.04.0−1.0
DD4Drug Safety and Accuracy of Drug Pricing4.04.0±0

Part C measures · health plan

Measure2027 result2027 starsvs 2026
C01Breast Cancer Screening82%4.0±0
C02Colorectal Cancer Screening77%4.0new spec
C03Annual Flu Vaccine74%5.0±0
C04Improving or Maintaining Physical Health72%3.0−1
C05Improving or Maintaining Mental Health86%4.0+2
C06Monitoring Physical Activity48%2.0±0
C07Special Needs Plan (SNP) Care ManagementPlan not required to report measure—
C08Care for Older Adults – Medication ReviewPlan not required to report measure—
C09Care for Older Adults - Functional Status AssessmentPlan not required to report measure—
C10Osteoporosis Management in Women who had a Fracture47%3.0−1
C11Diabetes Care – Eye Exam79%4.0+1
C12Diabetes Care – Blood Sugar Controlled90%4.0+1
C13Kidney Health Evaluation for Patients with Diabetes67%3.0−1
C14Controlling High Blood Pressure77%2.0−1
C15Reducing the Risk of Falling49%1.0−1
C16Improving Bladder Control38%2.0−1
C17Plan All-Cause Readmissions10%4.0+1
C18Statin Therapy for Patients with Cardiovascular Disease93%5.0±0
C19Transitions of Care59%3.0±0
C20Follow-up after Emergency Department Visit for People with Multiple High-Risk Chronic Conditions79%4.0−1
C21Getting Needed Care823.0−1
C22Getting Appointments and Care Quickly844.0±0
C23Customer Service925.0±0
C24Rating of Health Care Quality874.0±0
C25Rating of Health Plan874.0±0
C26Care Coordination873.0±0
C27Complaints about the Health Plan0.075.0±0
C28Members Choosing to Leave the Plan8%5.0±0
C29Health Plan Quality ImprovementMedicare shows only a Star Rating for this topic3.0−1
C30Plan Makes Timely Decisions about Appeals100%5.0±0
C31Reviewing Appeals Decisions97%3.0+1
C32Call Center – Foreign Language Interpreter and TTY Availability98%4.0+1

Part D measures · drug plan

Measure2027 result2027 starsvs 2026
D01Call Center – Foreign Language Interpreter and TTY Availability90%3.0−1
D02Complaints about the Drug Plan0.075.0±0
D03Members Choosing to Leave the Plan8%5.0±0
D04Drug Plan Quality ImprovementMedicare shows only a Star Rating for this topic3.0±0
D05Rating of Drug Plan862.0−1
D06Getting Needed Prescription Drugs904.0±0
D07MPF Price Accuracy1005.0±0
D08Medication Adherence for Diabetes Medications89%3.0±0
D09Medication Adherence for Hypertension (RAS antagonists)91%4.0±0
D10Medication Adherence for Cholesterol (Statins)90%4.0±0
D11Statin Use in Persons with Diabetes (SUPD)92%4.0±0
D12Concurrent Use of Opioids and Benzodiazepines (COB)14%3.0—
D13Polypharmacy: Use of Multiple Anticholinergic Medications in Older Adults (Poly-ACH)7%4.0—

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