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.
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.
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.
CareFirst increased revenues by 2% in 2011 to some $7.2 billion due to increased premiums and lower claims volumes, following a three-year growth trend from organic growth. Net income decreased by 37%, however, to some $122 million due to higher operating expenses and lower investment income levels.
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).
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