Speak Up: CareFirst's 2023 Annual Report Reflects Company's Commitment to Ethical Behavior, Compliance, Transparency
In 2022, CareFirst BlueCross BlueShield (CareFirst) remained the largest not-for-profit healthcare insurer in the mid-Atlantic region, employing nearly 5,800 full-time individuals and serving 3.6 million members in Maryland, Virginia, and Washington, D.C.
At CareFirst, our mission and values shape how we go about our work. How we do our jobs and treat each other is just as important as what we accomplish, and our commitment to our values requires the dedication and support of the entire organization.
"At CareFirst, we believe that when you do things, you do them the right way, for the right reasons, and in a compliant and highly ethical way. As CareFirst employees, we all have a duty to speak up when we see something that doesn't feel right."
Brian D. Pieninck, President and CEO, CareFirst BlueCross BlueShield
Our 2023 Annual Speak Up Report overviews our compliance and ethics processes. It highlights the company's notable trends and statistics in 2022 regarding reporting, investigating, and remediating issues. This report reflects our high standards for governance, compliance, and ethical behavior, which remain fundamental to our core values and help us deliver on our mission to provide affordable, accessible, and quality healthcare to everyone in our service region.
Every employee at CareFirst is expected to remain grounded in the values that have sustained our reputation as one of the most ethical healthcare companies in the industry. Our 2023 Speak Up Report reinforces our commitment to providing a safe space where employees know their voices will be heard and where we can each make a difference in contributing to an ethical and transparent culture.
2022 Key Highlights
Investigations
All reported issues are taken seriously and investigated to determine their context and cause, and find a solution when necessary. Additionally, investigations seek to identify any underlying issues or opportunities for improvement. Reporting issues is essential for a compliant and ethical culture.
Of the 78 investigations conducted in 2022:
- 58% were identified as substantiated, meaning some of all the allegations raised can be proven with reasonable certainty.
- 95% were completed, meaning the issue was investigated and is now closed. A summary of facts and conclusions was shared with business leadership. If substantiated, corrective action and appropriate communication were referred to relevant parties.
- CareFirst's Compliance Team conducted 41% of investigations, and CareFirst's Human Resources Team conducted 59%.
- 21% of investigations were reported by phone or e-mail, 23% were reported in person, and 56% were reported using CareFirst's web portal.
Employee Perception Survey
Each year, the Compliance and Ethics team oversees a survey of CareFirst employees' perception of the company's ethics and compliance. The results measure our ability to detect and prevent misconduct and our workforce's awareness of resources. It also helps identify opportunities for improvement and guide compliance and ethics efforts for the following year.
According to the 2022 Ethics and Compliance Perception Survey:
- 76.4% of respondents agreed that the company enforces its non-retaliation policy.
- 86.9% of respondents believed their manager complies with the non-retaliation policy.
- 93.9% of respondents said they knew how to make an anonymous report regarding wrongdoing or unethical behavior.
- 77.2% of respondents said the company handles ethical problems completely and appropriately.
