CareFirst PCMH reduces costs by $345 million

Baltimore, Md.-based CareFirst BlueCross BlueShield's patient-centered medical home reported improved care quality and $345 million less in costs than expected in 2014. This marks continued improvement from 2013, when costs were $130 million less than expected.

More than 4,300, or about 80 percent, of providers in the CareFirst service area, which includes parts of Northern Virginia, Washington, D.C., and Maryland, participate in the program, which launched in 2011.

Since then, the program has reduced the overall rates of increase in medical spending from 7.5 percent annually to 3.5 percent annually, and has cumulatively cost $609 million less than expected.

From its inception through today, the program has also reduced hospital admissions by 19 percent, length of stay by 15 percent and hospital readmissions by 20 percent. In 2014, the PCMH reduced hospital admissions by 5.1 percent, days in the hospital by 10.7 percent and readmissions by 8.5 percent.

"We expected from the outset that a program of this type would take time to be understood and embraced," said CareFirst President and CEO Chet Burrell in a statement. "This is what we are now seeing. PCPs want to take a lead role in their patients' healthcare, and our program provides the resources, data and incentives to let them do that."


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