Disease Management

To support your behavioral health treatment recommendations and plans of care, CareFirst provides several programs to help meet the specific needs of your patients, including:

• Clinical Support Team
  • Representatives who help patients find the right behavioral health provider for their situation and location, schedules the appointment and follows-up after the appointment.
  • Members should call 800-245-7013 for general support. If a patient is experiencing a crisis, help is available 24/7.
• Care Management
  • For patients with conditions like depression, autism spectrum disorder, or anxiety, this program provides one-on-one support through a specialty-trained and licensed behavioral health care manager.
• Substance Use Disorder Program
  • For patients struggling specifically with addiction or substance use, CareFirst offers trusted providers within outpatient addiction recovery centers who can provide treatment and care options, support groups, and education.
    
    Learn more about the Substance Use Disorder Program.
• Opioid Support
  • For patients who need support with opioid use or are struggling with opioid addiction, CareFirst has developed a holistic approach to combat the opioid epidemic through various strategies.

    Learn more about opioid prevention, treatment and resources

• Behavioral Health Digital Resource
  • This online behavioral health support platform gives members access to trained volunteer listeners, self-guided growth paths and treatment plans, community support and referrals to credentialed physicians in the CareFirst provider network.
  • Support is available 24/7 in more than 140 languages.
  • Learn more about this resource and display these posters in your office/patient waiting room(s) or as a handout—or both.

CareFirst offers several personalized programs to help our members who are at-risk for or already living with diabetes. These programs are part of their benefits and available at no additional cost.

Weight Management Programs

Because maintaining a healthy weight is key to overall health, we offer our members the choice of two psychology-based weight management programs* at no cost. Both programs feature a mindfulness approach to behavior change to help members achieve and sustain a healthier weight.

Members can see which program might be right for them by logging in to or signing up for CareFirst WellBeing. Once logged in, members should select You followed by Benefits. Next, click Health & Fitness to view the program descriptions, then choose a program to proceed to a health questionnaire to determine eligibility.

Diabetes Management Coaching Program

This program features one-on-one phone-based coaching sessions with a registered nurse specially trained to supports members with type 1 or type 2 diabetes:

• Personalized counseling
• Educational materials
• Online tools

CareFirst patients interested in learning about or joining the coaching program can call 877-515-2615.

Diabetes Virtual Care Program

This program offers support for patients who need help stabilizing their type 2 diabetes. Offered by CareFirst, along with Onduo**, a leading diabetes management company, this program provides patients with personalized support, easy-to-use tools and access to certified diabetes educators through a mobile app.

The program offers patients with the care and support they may need between doctor visits such as:

• Testing supplies and connected devices—patients will receive a welcome kit with a connected blood glucose meter and unlimited test strips shipped right to their door.
• Personalized one-on-one virtual coaching—patients can also chat with their personal care lead to set up a plan to improve nutrition, start an exercise program, or meet a health goal.
• Virtual doctor visits—patients can schedule a telehealth visit with an endocrinologist or certified diabetes educator, as needed, to receive personal recommendations and guidance to manage any symptoms. Onduo will help patients coordinate information with their doctor.

Refer today. Patients may self-enroll in the Diabetes Virtual Care program by visiting Onduo.com/CareFirstRefer.

^* Not available for Individual health plan members. Members need to meet clinical eligibility criteria to be eligible for the weight management programs. These services are administered by Sharecare, Inc. or Noom, independent companies which provide health improvement management services to CareFirst members. Sharecare, Inc. and Noom do not provide CareFirst BlueCross BlueShield products or services and are solely responsible for the health improvement management services they provide.

^** This program is provided by Onduo, LLC an independent company that does not provide Blue Cross Blue Shield products or services.

CareFirst offers a free, comprehensive disease management program for members who have or are at risk for congestive heart failure (CHF) and coronary artery disease (CAD). This confidential, voluntary program:

• provides routine updates to keep physicians informed about patients' progress and adherence to the plan of care 
• takes note of the high rate of heart disease among persons with diabetes 
• reinforces the physician's plan of care 
• is administered by Healthways, Inc. 

Eligible members:

• can reach a nurse by phone 24 hours a day 
• are assigned a nurse care manager (if greater disease severity exists) 
• receive educational materials, including condition-specific workbooks, action plans and newsletters. 

To obtain more information, refer a patient or if you are a member and want to self-refer, please call the CHF/CAD management program at (800) 783-4582.

CareFirst supports the American Heart Association Clinical Guidelines. You may obtain a copy of these guidelines at www.americanheart.org. 

CareFirst's cancer management program seeks to ensure the best possible outcomes for members with cancer.

Enrolled members are assigned to an experienced oncology Care Manager, who:

• monitors their progress in conjunction with the physician's plan of care 
• provides educational and emotional support 
• is available by calling (888) 264-8648 Monday - Friday from 8:30 a.m. to 4:30 p.m. 

Providers may refer a member to the oncology program by calling (888) 264-8648.

CareFirst offers free, comprehensive disease management programs for members with asthma and chronic obstructive pulmonary disease (COPD). These confidential, voluntary programs:

• help members learn how to self-manage their condition
• reinforce the physician's plan of care
• are administered by Healthways, Inc.

Enrolled members:

• can access a nurse by phone 24 hours a day, 7 days a week
• are assigned a nurse care manager, if disease is severe
• receive educational materials, including condition-specific workbooks, action plans and newsletters.

To obtain more information, refer a patient or if you are a member and want to self-refer, please call the Asthma Management Program at (800) 783-4582.