CareFirst BlueCross BlueShield Announces Agreements to Acquire Medicaid MCO Plans in Maryland and Washington, D.C.
Posted on 2019-12-20
Updated on 2019-12-20 09:29:36
Transactions are pending regulatory review and approval
Baltimore and Washington, D.C. – To advance its mission to provide affordable access to health coverage, CareFirst BlueCross BlueShield (CareFirst) today announced it has reached separate definitive agreements to acquire Trusted Health Plan (Trusted) in Washington, D.C. and University of Maryland Health Partners (Health Partners) in Baltimore. Trusted operates as a Medicaid managed care organization exclusively in Washington, D.C. and Health Partners currently serves Medicaid enrollees in 20 Maryland Counties and Baltimore City.
Health Partners is owned by the University of Maryland Medical System (UMMS) and the Boards of Directors of both CareFirst and UMMS have approved the acquisition. Similarly, the Boards of CareFirst and Trusted have approved CareFirst’s acquisition of Trusted. Completion of the transactions is subject to fulfillment of various conditions, including regulatory approvals from the District of Columbia and the State of Maryland.
“Our unique not-for-profit mission calls on us to provide access to affordable health coverage and to support public and private initiatives that provide coverage for the individuals and families in the communities we serve,” said CareFirst President & CEO Brian D. Pieninck. “We want to help people meet health care needs at every stage and in every circumstance of life – and for many, Medicaid represents the most affordable coverage.”
Trusted began operations in 2013 and currently serves more than 34,000 enrollees in Washington, D.C. – coverage and services will not change as the acquisition undergoes regulatory review and approval.
“Trusted looks forward to integrating into CareFirst,” said Trusted CEO Tommy Duncan. “We believe that the combination of Trusted’s high-touch model of care coupled with CareFirst’s deep experience in managing the care for high acuity populations will yield the most comprehensive care for District enrollees in the Medicaid program.”
Health Partners currently serves 47,000 enrollees. There will be no immediate changes to the coverage and services of Health Partners enrollees. Not included in the transaction is the University of Maryland Health Advantage (UMHA) plan. UMMS will continue to own and operate the UMHA plan through which 5,600 Marylanders who are enrolled in both Medicare and Medicaid are covered now, and will remain covered, after the approval of the Health Partners acquisition.
“The University of Maryland Medical System and CareFirst have always been strong allies and the acquisition of Health Partners further solidifies that alignment,” said Mohan Suntha, MD, MBA, President and CEO of UMMS. “More importantly, it ensures our Medicaid enrollees have uninterrupted access to comprehensive health coverage and care through partnership with a Maryland-based, not-for-profit health plan. Delivering high quality, compassionate care is fundamental to the missions both UMMS and CareFirst serve and we are confident that Health Partner enrollees will benefit from CareFirst’s expertise in the market.”
“We strongly believe we can do more to improve the health of the communities we serve. Working more closely with leading health providers such as UMMS opens a great opportunity to collaborate and achieve broader community impact moving forward,” Pieninck said. “And, as a community-focused health company, it’s important that whenever possible we strive to serve the entire region. By acquiring both Trusted and Health Partners, we will – in relatively short order – expand our mission and service commitment to Medicaid enrollees in the District and most of Maryland.
“Through these acquisitions CareFirst will be able to extend the wide array of health services and expertise available to its current members to the Medicaid population,” said Pieninck. “We are excited to welcome Medicaid enrollees into the CareFirst community.”
After the transactions close, CareFirst plans to bring Trusted and Health Partners into its not-for-profit organizational structure to better align with its mission. CareFirst will develop a plan to integrate both companies’ staffs and infrastructure with CareFirst operations over a multi-year transition period that allows all companies to continue meeting the needs of Medicaid enrollees without interruption.
About CareFirst BlueCross BlueShield
In its 82nd year of service, CareFirst, an independent licensee of the Blue Cross and Blue Shield Association, is a not-for-profit health care company which, through its affiliates and subsidiaries, offers a comprehensive portfolio of health insurance products and administrative services to 3.2 million individuals and groups in Maryland, the District of Columbia and Northern Virginia. In 2018, CareFirst invested $38 million to improve overall health, and increase the accessibility, affordability, safety and quality of health care throughout its market areas. To learn more about CareFirst BlueCross BlueShield, visit our website at www.carefirst.com or follow us on Facebook, Twitter, LinkedIn or Instagram.
About the University of Maryland Medical System
The University of Maryland Medical System (UMMS) is a university-based regional health care system focused on serving the health care needs of Maryland, bringing innovation, discovery and research to the care we provide and educating the state’s future physician and health care professionals through our partnership with the University of Maryland School of Medicine and the UM Schools of Nursing, Pharmacy, Social Work and Dentistry in Baltimore. As one of the largest private employers in the State, the health system’s 28,000 employees and 4,000 affiliated physicians provide primary and specialty care in more than 150 locations and at 13 hospitals. UMMS’ flagship academic campus, the University of Maryland Medical Center in Baltimore is partnered with the University of Maryland School of Medicine and is recognized regionally and nationally for excellence and innovation in specialized care. Our acute care and specialty rehabilitation hospitals serve urban, suburban and rural communities and are located in 13 counties across the state. In addition, UMMS operates health insurance plans serving Medicare and Medicaid members. For more information, visit www.umms.org. Health Partners members should continue to call the member services department at 410-779-9369 or 1-800-730-8530, or visit the Health Partners website at www.umhealthpartners.com.
Trusted Health Plan, also known as Trusted, is a high-performing managed care organization serving enrollees of the DC Healthy Families Medicaid Program and the DC Healthcare Alliance Program. In operation since 2013, Trusted now manages the care of over 34,000 enrollees, and employs over 125 full-time employees. Trusted was the first Medicaid managed care organization in D.C. to introduce Wellness Centers, giving enrollees access to face-to-face health education, case management, and nutritional counseling in centers located in Wards 4, 7, and 8. Trusted has continuously exceeded the requirements of the District’s managed care organization Pay for Performance Program since its inception, improving performance in each of the three utilization measures: low acuity non-emergent emergency department admissions (LANE), potentially preventable admissions (PPA), and 30-day inpatient readmissions (30R). Trusted enrollees should continue to call enrollee services at 202-821-1100 or visit the Trusted website at www.trustedhp.com.