CareFirst BlueCross BlueShield (CareFirst) recently hosted a panel discussion, The Value of Value-Based Care: Transforming Today’s Models for Tomorrow’s Care, at its Baltimore headquarters. The event was also livestreamed to reach a broader audience.
Tinna Quigley, Vice President of Government Affairs for Maryland, opened the event. Zach Rabovsky, Director of Population Health at CareFirst, moderated a dynamic panel featuring:
- Mike Ferson, Senior Partner, HealthScape Advisors
- Simeon Niles, Director, McDermott+Consulting
- Dr. Sharon Feinstein, Assistant Professor and Director of Value-Based Programs, University of Maryland School of Medicine
What Is Value-Based Care?
Value-based care (VBC) shifts healthcare reimbursement from volume to outcomes. Instead of paying for the number of services delivered, VBC rewards improvements in patient health, chronic disease management and care coordination. These models promote prevention, team-based care and stronger patient -provider engagement—while reducing unnecessary costs.
CareFirst’s Leadership in Value-Based Innovation
CareFirst has been a pioneer in value-based care since launching its Patient-Centered Medical Home (PCMH) model in 2011. This model gives primary care providers a wholistic view of patient needs and the services across the care continuum. Over time, CareFirst has expanded into shared savings, bundled payments, capitation and accountable care contracts—driving better outcomes and smarter risk management.
Key Takeaway from the Panel
- Interdisciplinary Partnerships: Success in value-based care depends on collaboration. As Mike Ferson noted, transformation requires more than contracts—it demands integrated partnerships between payers, providers and policymakers. Simeon Niles emphasized that commercial insurers like CareFirst are uniquely positioned to test new models and align across payers.
- Aligning Incentives and Reducing Burden: Dr. Feinstein highlighted the challenge of juggling unaligned metrics across platforms. She praised CareFirst’s coaching and data tools for helping providers focus on care delivery while reducing administrative strain.
- Behavioral Health and Pharmacy Integration: Panelists stressed the importance of embedding behavioral health and pharmacy services into primary care. Dr. Feinstein shared how her clinic added behavioralists and clinical pharmacists to better support patients with complex needs—enabled by value-based funding.
- Addressing Social Drivers of Health: Simeon Niles reflected on his work designing the Accountable Health Communities model at the Center for Medicare and Medicaid Innovation. He and other panelists emphasized integrating non-clinical supports—like housing, food and transportation—into care delivery to improve outcomes and reduce costs.
- Real-World Implementation: Policy alone isn’t enough. The panel discussed the need for infrastructure like care coordination, shared data and embedded team members. Dr. Feinstein shared how dashboards and monthly coaching help her clinic identify high-need patients and drive quality improvements.
Looking Ahead
CareFirst remains committed to expanding value-based care to improve the health outcomes and support provider success. This event underscored both the momentum and the challenges of building a more sustainable, equitable healthcare system.
Missed the event? Watch the recording above and explore how CareFirst and our partners are shaping the future of commercial value-based care. Together, we can build a system that works better for everyone.