CareFirst Announces PCMH Program Results

Lena J. Weiner, July 17, 2014

The Washington, DC health plan provider says it has improved healthcare access for at-risk populations while lowering costs.

CareFirst BlueCross BlueShield, the dominant health plan provider for the Washington, DC area, says it has a secret sauce for reducing costs for insuring high-risk populations while improving their health.

Last week, flanked by Johnathan Blum, former principal deputy administrator and director of the Centers for Medicare & Medicaid Services, and others, Chet Burrell, CEO and President of CareFirst announced that, for a third consecutive year, the organization's Patient Centered Medical Home Program has achieved lower than expected costs.

Launched in January 2011, the PCMH program was designed to incentivize primary care providers to offer a care coordination program to CareFirst customers. It also offers access to tools and support to offer care that is theoretically higher in quality and lower cost.

The program specifically aims to work with patient populations that would benefit from personalized medical attention, such as those with multiple chronic conditions. Another goal of the program is to help these patients better manage their diseases and improve their overall health through collaboration with panels of five to 15 physicians and nurse coordinators.

Lena J. Weiner

Lena J. Weiner is an associate editor at HealthLeaders Media.

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