Frequently Asked Questions

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Did the PCMH program go away?

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.

Why are members no longer required to select a PCP who participates in the PMCH program?

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.

If members keep/select a PCMH PCP, will they still earn a reward for that activity?

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

Were there any other changes for Blue Rewards?

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

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