CareFirst Patient-Centered Medical Home Program Nets $1.2B In Savings Since 2011

 Since it was launched in January 2011, the Patient-Centered Medical Home (PCHM) program operated by CareFirst BlueCross BlueShield (CareFirst) has lowered the expected cost of care for CareFirst members by nearly $1.2 billion.

In 2017 alone, CareFirst’s PCMH program – the largest coordinated care program of its kind in the country – helped save $223 million against the expected cost of care. The savings are fueled primarily by reductions in hospital admissions and readmissions and how long patients stay in the hospital once admitted.

Now in its eighth year of operation, CareFirst’s PCMH program and its supporting Total Care and Cost Improvement (TCCI) programs have contributed to dramatic slowing in the rise of health care costs for members of the mid-Atlantic’s largest health insurer. CareFirst’s overall medical trend – a measure of annual total growth in all health care costs, including pharmacy – averaged just 3.5 percent from 2013 to 2017, compared with an average of 7.5 percent rise in cost per year in the five years prior to the PCMH program’s launch.