About GROUP HOSPITALIZATION AND MEDICAL SERVICES, INC.

CareFirst makes health care coverage its No.1 priority. The firm is a not-for-profit, non-stock holding company with subsidiaries providing managed health care plans to about 3.4 million members in Maryland and Washington, DC. The company's main subsidiaries, CareFirst of Maryland and Group Hospitalization and Medical Services are licensees of the Blue Cross and Blue Shield Association. Together, the subsidiaries do business as CareFirst BlueCross BlueShield and offer Blue-branded HMO and PPO plans, as well as consumer-driven coverage, to individuals and employers throughout their service areas. Non-Blue subsidiaries and affiliates provide third-party benefits administration and claims processing services.

Geographic Reach

CareFirst's products are offered to individuals and businesses large and small in Delaware and the Washington, DC, metropolitan area, including portions of northern Virginia, West Virginia, and North Carolina. It is the largest provider of its kind in the region with more than 80% of the area's health care providers participating in the CareFirst networks. 

Operations

The company offers a broad portfolio of health insurance products and administrative services. In addition to traditional and consumer-driven (high deductible, low premium) plans, CareFirst also provides some Medicare and Medicaid options, and it serves some 580,000 members in the Federal Employees Health Program.

In addition to CareFirst of Maryland and Group Hospitalization and Medical Services, the company offers HMO products through its for-profit CareFirst BlueChoice subsidiary. The company's National Capital Administrative Services (NCAS) unit offers third-party administration of corporate benefits packages, while the CASCI division provides claims processing services for the Federal Employee Plan.

Sales and Marketing

CareFirst markets through display and broadcast TV advertising in Maryland and the Washington, DC area. It uses digital advertising primarily via social networking sites and mobile apps. The system also markets its products and services through sales representatives.

Strategy

With health care costs continuing to rise, the company has been looking for ways to reduce costs across the board. Its Primary Care Medical Home (PCMH) program is designed to lower costs related to caring for chronically ill patients by establishing primary care providers to coordinate their care. Its HealthyBlue program offers incentives for getting healthy and taking control of one's own well-being (such as quitting smoking or losing weight). In addition, CareFirst is introducing more affordable coverage options, such as plans that are eligible for use with health savings accounts (HSAs).

In 2013 CareFirst made an investment of $20 million in Healthways as part of an expanding partnership between the two firms. (In 2012 CareFirst and Healthways announced an expansion and extension through mid-2016 of their partnership, helping CareFirst deliver its network-wide Patient-Centered Medical Home program).

In 2013 the company opened a new mobile unit geared to educate people about the Affordable Care Act, inform them of new coverage options, and help enroll them in the new health care insurance opportunities provided by the Act.

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GROUP HOSPITALIZATION AND MEDICAL SERVICES, INC.

10455 Mill Run Cir
Owings Mills, MD 21117-4208
Phone: 1 (202) 479-8000
Fax: 1 (202) 680-7611
www.carefirst.com

Stats

  • Employer Type: Public
  • Managing Director: Denise Burrows
  • Managing Director: Virginia McDonald
  • Chief Executive Officer: Debbie Tyner

Major Office Locations

  • Owings Mills, MD

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