Frequently Asked Questions

No, the PCMH program did not go away. PCMH continues to be an essential part of CareFirst’s value-based care strategies focused on PCPs. We continue to evolve the program’s methodology to ensure we are incentivizing provider behaviors that further drive better quality care at a lower cost.

We updated core components of the program based on feedback from participating PCPs and from the employer groups whose employees we serve. We understand members have longstanding, trusting relationships with PCPs who do not participate in our PCMH program. To honor those relationships and encourage continued engagement with their providers and overall health, we will equally reward the selection of a PCMH PCP or an in-network PCP.

Yes, as long as they keep/select an in-network PCP, they are still eligible to earn a reward.

No, removing the PCMH requirement to earn a reward was the only change. To earn rewards, members should:

1. Consent to receive wellness emails and take the RealAge® test
2. Select an in-network PCP and complete a health screening
3. Retake the RealAge test