Signature Programs

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Patient-Centered Medical Home Program

CareFirst’s Patient-Centered Medical Home (PCMH) Program creates a model of coordinated care designed to better manage overall health care costs while improving health care quality – particularly for those members managing chronic disease. The PCMH Program combines nursing support, specialized programs, online tools and incentives that allow primary care providers to more effectively serve as the “quarterback” of a care-giving team.

CareFirst’s PCMH program incentivizes primary care physicians to earn rewards for helping CareFirst members with the most pressing health care needs – those with multiple chronic conditions like diabetes, asthma and high blood pressure that are at great risk for worsening health.

Launched in January 2011, the PCMH Program is one of the nation’s most mature and established medical home programs of its kind. In each year since the program was launched, CareFirst has seen measurable improvements in key quality indicators and savings against the projected cost of care for members covered by the program.

For a complete description of the program, please review our PCMH Program Description and Guidelines.

Total Care and Cost Improvement Program

All 3.2 million CareFirst members have access to one or more elements of the company’s Total Care and Cost Coordination (TCCI) Program. Designed to offer members the right service at the right time and at the right level, the TCCI Program allows health care providers to easily bring the benefits of a host of established programs to members whenever needed.

In all, there are 20 TCCI Program elements in place, including telemedicine, pharmacy coordination, behavioral health and substance abuse, hospital transition and care, chronic care coordination and complex case management, among others.

Implementation of the TCCI program helps increase the coordination of all types of care services – across provider type, setting and time – for members, including those who need the most assistance in managing and preventing illness.

For a complete description of the program, please review our TCCI Program Description and Guidelines.

Blue Rewards

Blue Rewards is CareFirst’s exclusive incentive program where members can earn money for taking steps toward getting and staying healthy. Participating members can apply the financial reward to a deductible, copay or coinsurance.

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