CareFirst makes health care its No.1 priority. The firm is a not-for-profit, non-stock holding company with subsidiaries providing managed health care plans to about 3.3 million members in Maryland and Washington, DC. The company's main subsidiaries, CareFirst of Maryland and Group Hospitalization and Medical Services are licensees of theBlue Cross and Blue Shield Association. Together, the subsidiaries do business as CareFirst BlueCross BlueShield and offer Blue-branded HMO and PPO plans, as well as consumer-driven coverage, to individuals and employers throughout their service areas. Non-Blue subsidiaries and affiliates provide life insurance and third-party benefits administration.
CareFirst's products are offered to individuals and businesses large and small in Delaware and the US Capital (including DC and Northern Virginia). It is the largest provider of its kind in the region with more than 80% of the area's health care providers participating in one or more of CareFirst's plans. In addition to traditional and consumer-driven (high deductible, low premium) plans, the company also provides some Medicare and Medicaid options, and it serves more than 570,000 members in the Federal Employees Health Program.
With health care costs continuing to rise, the company has been looking for ways to reduce costs across the board. It came up with a program called Primary Care Medical Home (PCMH) designed to lower costs related to caring for chronically ill patients. According to the company, the sickest 10% of CareFirst members are responsible for roughly 60% of all medical costs paid out by CareFirst. The PCMH program establishes primary care providers to coordinate the care of chronically ill and patients with serious health problems- such as diabetes, asthma, and high blood pressure. In return for putting greater focus on such patients, physicians are given financial incentives. About 3,000 primary care providers in CareFirst's networks have joined the voluntary program.
CareFirst operates a similar program for patients. The HealthyBlue program offers incentives for getting healthy and taking control of one's own well-being (such as quitting smoking or losing weight). Both HealthyBlue and PCMH are also meant to improve access to health care and are part of a larger industry trend of focusing on the health of the whole person, not just fixing an existing illness.
In addition to CareFirst of Maryland and Group Hospitalization and Medical Services, the company offers HMO products through its for-profit CareFirst BlueChoice subsidiary. The company's National Capital Administrative Services (NCAS) unit offers third-party administration of corporate benefits packages, while its NCIA Insurance Agency unit offers group life and disability insurance through a partnership with Fort Dearborn Life. – less