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Maryland Women’s Coalition for Health Care Reform PowerPoint Presentation
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Maryland Women’s Coalition for Health Care Reform - PowerPoint PPT Presentation


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Maryland Women’s Coalition for Health Care Reform. Maria Harris Tildon Senior Vice President Public Policy and Community Affairs CareFirst BlueCross BlueShield. The CareFirst Organization. The largest insurer in the Mid-Atlantic region, serving 3.4 million members

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Presentation Transcript
slide1

Maryland Women’s Coalition

for Health Care Reform

Maria Harris Tildon

Senior Vice President

Public Policy and Community Affairs

CareFirst BlueCross BlueShield

slide2

The CareFirst Organization

  • The largest insurer in the Mid-Atlantic region, serving 3.4 million members
  • Employs about 5,000 associates and contractors in Maryland, Washington, D.C., Northern Virginia, West Virginia and North Carolina
  • Has the largest provider network in the region, with more than 80 percent of the region’s health care providers participating in one or more networks
  • Has launched the nation’s largest Patient-Centered Medical Home (PCMH) program of its kind
  • Contributed more than $51 million in 2011 to community programs designed to increase health care access, affordability, safety and quality throughout Maryland and the National Capital Area
  • The CareFirst Mission
  • Offer a broad array of quality, innovative insurance plans and administrative services that are affordable and accessible to our customers
  • Fairly address the needs of customers in each of the jurisdictions in which we operate
  • Conduct business responsibly as a not-for-profit health services plan, to ensure the plan's long-term financial viability and growth
  • Collaborate with the community to advance health care effectiveness and quality
  • Support public and private efforts to meet the needs of the uninsured
slide3

Improving Health Outcomes and Bending the Cost Curve

Through Corporate and Community Initiatives

  • CareFirst’s Patient-Centered Medical Home
  • CareFirst’s Patient Centered Medical Home (PCMH) program provides tools and incentives to help primary care physicians serve as the quarterback of a team to coordinate care for those patients with the greatest needs
  • Program launched in 2011 with approximately 2,200 participating Primary Care Providers (PCPs)
  • Today, 3,600 PCPs are participating in the program in roughly 400 Panels, representing 85% of all eligible PCPs in our networks and making it one of the largest programs in the nation
  • Approximately 1 million CareFirst members are attributed to the physicians participating in the PCMH program
  • Participating providers are given a variety of supports to help them better monitor and coordinate care, including:
    • Access to a registered nurse, local care coordinator in their community to work with them to develop a care plan and to work directly with the patient to adhere to the plan
    • Online tools to create and track care plans and to see a host of information that allows them to better manage the care of their patients
    • A team of CareFirst consultants to help them analyze program data and recognize opportunities to further improve care
slide4

Improving Health Outcomes and Bending the Cost Curve

Through Corporate and Community Initiatives

  • CareFirst Safety Net Health Center Medical Home Initiative
  • In 2012, CareFirst committed $8.5 million in funding to help safety net health center programs in Maryland, Washington, D.C., and Northern Virginia to implement patient-centered medical homes and care coordination programs for the region’s most vulnerable population, the chronically ill
  • Safety Net Health Centers provide services to low-income and medically underserved communities:
    • Addresses chronic illnesses such as diabetes, cardiovascular disease, and high-blood pressure
    • Also deal with a wide spectrum of other medical issues, including primary adult care and pediatric health, specialized care with HIV-targeted case management, and specialized services for homeless, minority and uninsured populations
  • Programs are expected to provide services to as many as 66,000 individuals at more than 20 locations throughout the region
  • Participating providers are given a variety of supports to help them better monitor and coordinate care, including:
    • Access to a registered nurse, local care coordinator in their community to work with them to develop a care plan and to work directly with the patient to adhere to the plan
    • Online tools to create and track care plans and to see a host of information that allows them to better manage the care of their patients
    • A team of CareFirst consultants to help them analyze program data and recognize opportunities to further improve care
slide5

Improving Health Outcomes and Bending the Cost Curve

Through Corporate and Community Initiatives

Regions Serviced by Safety Health Centers Patient Centered-Medical Home Projects

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Improving Health Outcomes and Bending the Cost Curve

Through Corporate and Community Initiatives

  • CareFirst’s Five Key Strategic Community Initiatives
  • Empowering the region’s Safety Net Health Clinics and promoting the Patient-Centered Medical Home Concept are two of CareFirst’s five key strategic community initiatives. CareFirst is also committed to:
  • Improving Maternal and Child Health
    • Provided more than $9 million since 2006 to community-based efforts to improve maternal, infant and child health in communities where the need is the greatest.
  • Battling Childhood Obesity
    • Since 2006, CareFirst has invested more than $3 million in efforts to reduce childhood obesity
  • Addressing the Region’s Shortage of Nurses
    • ThroughProject RN, CareFirst provides grants to nurses to earn graduate nursing degrees in exchange for commitments to teach for at least three years in nursing education programs in our region. To date, Project RN scholarships provided $80,000 stipends to 30 students in Maryland, Washington and Northern Virginia