CareFirst Aims to Close Gaps in Care
CareFirst BlueCross BlueShield (CareFirst) is taking an active role in making sure that our members, your patients, receive the care needed to address their healthcare conditions.
One of the ways we are doing this is by incorporating gaps in care messaging into our interactions with members. For example, claims data may reveal that a member who is calling our customer service team has not had their recommended screenings for cervical, colorectal or breast cancer. In that case, we discuss those screenings with the member and recommend they reach out to their primary care provider (PCP) with questions related to their preventive screenings or directly schedule their screening.
Additionally, CareFirst proactively sends targeted mailers to members identified through claims analysis as having gaps in care for specific Healthcare Effectiveness Data and Information Set® measures. The mailer encourages members to schedule a visit with their PCP to discuss recommended preventive measures, such as having a retinal eye exam or a HbA1c lab test if they have diabetes.
As a result of CareFirst’s efforts, you may see an increase in patients requesting wellness visits and/or asking about recommended preventive measures. Information about preventive care is available for members at www.carefirst.com/prevention.