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About Group Hospitalization and Medical Services, Inc.

CareFirst is a not-for-profit, non-stock holding company with subsidiaries providing managed health care plans to about 3.3 million members in Maryland, Northern Virginia, and Washington, DC. It is the largest health insurer in Maryland. The company's main subsidiaries, CareFirst of Maryland, CareFirst BlueChoice, 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.

Operations

CareFirst offers a broad portfolio of health insurance products and administrative services. In addition to traditional and consumer-driven (high deductible, low premium) plans, CareFirst provides limited Medicare and Medicaid options, and it serves some 626,000 members in the Federal Employees Health Program. The company offers HMO products through its for-profit CareFirst BlueChoice subsidiary. 

Geographic Reach

CareFirst's products are offered to individuals and businesses large and small in Maryland and the Washington, DC, metropolitan area, including portions of northern Virginia.

Financial Performance

In 2018, CareFirst had revenue totaling $9.4 billion. Its net income totaled $138.9 million that year. 

Strategy

With health care costs continuing to rise, CareFirst 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. Since its founding in 2011, PCMS members have had more than 20% fewer hospital admissions and emergency room visits, and they've spent an average of eight fewer days in the hospital.

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).

The company is broadening its governmental program activities. It is exploring the idea of entering the Medicare and Medicaid Advantage markets by 2021, after nearly 20 years of being off of those markets. CareFirst currently only operates in the Medicaid supplemental market.

Company Background

CareFirst's family tree has several roots, which trace back to 1934. Its predecessors include Group Hospitalization, Associated Hospital Service of Baltimore (later renamed Maryland Hospital Service), Medical Service of the District of Columbia, and Maryland Medical Service (later named Maryland Blue Shield).

Maryland and Washington Blues joined forces to create holding company CareFirst in 1998.

Group Hospitalization and Medical Services, Inc.

10455 MILL RUN CIR
Owings Mills, MD 21117-4208
Phone: 1 (202) 479-8000

Stats

Employer Type: Privately Owned
Vice President, Pharmacy: Arif Khan
Mid Market, New Business Consultant: Renee Pigg
Account Manager: Chris Stolze
Employees (This Location): 1,200
Employees (All Locations): 2,000

Major Office Locations

Owings Mills, MD

Other Locations

Salisbury, MD