CareFirst Launches Blue High Performance NetworkSM Offering and Advances Value-based Care Partnerships

older man having virtual doctor visit The healthcare system has a pressing need to increase the number of providers in value-based care arrangements. Unlike the traditional fee-for-service model, value-based care ties provider revenue to individuals’ improved health outcomes and the value of services delivered rather than the volume of office visits.

CareFirst BlueCross BlueShield (CareFirst) champions the importance of transitioning to a value-based care system and is committed to bringing affordable, high-quality healthcare to our members. That’s why we introduced the Blue High Performance NetworkSM (BlueHPNSM).

Plan options are now available for the fully insured and self-insured market with effective dates starting April 1, 2022.

Local expertise, national collaboration

Healthcare is local. Issues like quality of care, cost and access vary across communities. BlueHPN was designed by local experts who could take advantage of deep data and strong provider relationships.

CareFirst’s local BlueHPN is part of a national network collaboration, which covers the 65 BlueHPN markets, including the top 10 U.S. cities. It includes primary care physicians, hospitals and specialists for each market that will enhance care quality and lower cost.

Provider selection

Every provider selected to participate in CareFirst’s BlueHPN commits to making continuous improvements to quality of care, cost efficiency, clinical coding and performance measures. In addition, they must focus on delivering value-based care.

In order to build BlueHPN, CareFirst included providers focused on improving value and outcomes for their patients as measured by our Provider Profile Score. While this means a smaller pool of in-network physicians, it also means that every provider is dedicated to delivering high quality care at lower costs for our members and employers.

New $0 virtual care benefit

As CareFirst continues to invest in innovations to transform the way healthcare works, we also continue to evaluate how we can enhance BlueHPN to meet more of our members’ needs. A good example of this is CloseKnit, a new virtual-first, primary care practice that’s now available to our members.

CloseKnit is a different kind of primary care practice, designed to be everything virtual care should be, and then some. For instance, CloseKnit delivers:

  • Virtual care 24/7/365 through an easy-to-use app, plus in-person or specialty care when needed.
  • Preventive and urgent care services, plus behavioral and mental health support, care coordination, insurance navigation, and more.
  • Another option for members when their primary care provider (PCP) isn’t available, plus the opportunity to take their relationship a step further by making CloseKnit their PCP if they don’t have one.

Nearly 40% of CareFirst members have not selected a PCP. Considering we’re facing a physician shortage, with the Association of American Medical Colleges predicting a deficit of up to 139,000 primary care and specialty physicians by 2033—this percentage could rise dramatically. But with innovations like CloseKnit, we hope to increase member access to PCPs and better support physicians through improved coordination of care.

That’s why we’re excited to connect more members to the many benefits and conveniences of CloseKnit. Now, all our non-Health Savings Account (HSA) BlueHPN plans include a $0 virtual care benefit for primary care and behavioral health visits through CloseKnit.

Leveraging telehealth, and investing in it, is an integral part of CareFirst’s long-term vision to increase member access to affordable quality care. The intent is not to replace in-person care but to augment it—making care as easy to use, get and afford for many people as possible. The launch of BlueHPN paired with virtual care through CloseKnit brings us closer to achieving our mission of equitable, value-oriented, accessible healthcare for our members.

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