CareFirst Acquisition of UMMS Health Plans is Catalyst for New Partnership to Transform the delivery of Healthcare
October 13, 2020
Baltimore, Md. — CareFirst BlueCross BlueShield (CareFirst), the region’s largest not-for-profit healthcare company, and the University of Maryland Medical System (UMMS) today announced a new five-year partnership to address access and quality of care for the state’s most vulnerable populations. The transformative work from this initiative will focus on population health, which is an approach to care aiming to improve the health outcomes for entire patient populations while also improving the healthcare experience and effectively managing costs. This includes enhanced support and focused care for the highest-risk patients (i.e. individuals with chronic conditions such as diabetes, heart failure, lung disease, health inequities) to help them maintain a high quality of life through more efficient and effective management of their health. As part of this effort, CareFirst BlueChoice, Inc. will acquire University of Maryland Health Advantage, Inc. (UM Health Advantage), a Medicare Dual Eligible Special Needs health plan, and CareFirst Community Health Plan Maryland, Inc., a Medicaid Managed Care Organization. Combined, UMMS’ Health Plans serve 55,000 Maryland residents each year.
At the core of this partnership is the development of a jointly operated population health management team which will allow UMMS and CareFirst to collaborate on innovative care models and related resources, better enabling both organizations to focus on what they do best. Specifically, the work will bring new approaches to using shared data that drive improved population health outcomes by supporting the identification and delivery of the most effective care and support for vulnerable populations. This joint effort allows CareFirst and UMMS to take coordinated action, focused on investing in healthier communities and improving health equity in Maryland. This collaboration also marks a shared commitment to expanding partnerships designed to transform care delivery and improve health outcomes.
CareFirst’s expertise in provider and population performance measurement will support UMMS’ key strategic objectives to better orient its hospitals and community practices for population health activities and clinical integration. This will result in better performance on clinical, quality, affordability and patient experience measures for all populations served by both organizations.
“With this partnership, we are substantially expanding CareFirst’s commitment to advancing more accessible and more affordable healthcare for all Marylanders. As a not-for-profit healthcare company, serving all residents through time and circumstance is an essential expression of our mission,” said Brian D. Pieninck, CEO and President of CareFirst. “This partnership brings the best capabilities of CareFirst and UMMS together in a new model and is part of our broader efforts designed to deliver care focused on value and improved health outcomes. Our work with the UMMS team will provide opportunities for deeper collaboration and innovation designed to bring our shared communities greater value, expanded access to high quality care, better consumer experiences, and more equitable care for all Maryland residents.”
“Our system is wholly dedicated to providing compassionate, high-quality, patient- and family-centered care, and this unwavering commitment to the health and well-being of Marylanders extends far beyond the walls of our hospitals,” said Mohan Suntha, MD, MBA, President and CEO of UMMS. “The transition of our Health Plans to CareFirst means our patients will have access to a wider range of services that they can count on to help manage their health, and will get access to providers throughout the State. The deepening of our longstanding partnership with CareFirst opens up exciting new possibilities to better serve our communities’ vulnerable populations together.”
CareFirst BlueChoice, Inc. is acquiring the UMMS’ Health Plans intact so the providers in the UMMS network today will continue to be available to patients. No disruption to members is expected. Over the course of the next 12 months, the Dual Eligible Special Needs health plan will become known as CareFirst BlueCross BlueShield Medicare Advantage and the Medicaid Plan will become known as CareFirst BlueCross BlueShield Community Health Plan Maryland. Finalizing the acquisition and rebranding will be subject to regulatory approval as well as the consent of the Centers for Medicare & Medicaid Services and the State of Maryland.
About University of Maryland Medical System
The University of Maryland Medical System (UMMS) is a university-based regional health care system focused on serving the health care needs of Maryland, bringing innovation, discovery and research to the care we provide and educating the state’s future physician and health care professionals through our partnership with the University of Maryland School of Medicine and the UM Schools of Nursing, Pharmacy, Social Work and Dentistry in Baltimore. As one of the largest private employers in the State, the health system’s 28,000 employees and 4,000 affiliated physicians provide primary and specialty care in more than 150 locations and at 13 hospitals. UMMS’ flagship academic campus, the University of Maryland Medical Center in Baltimore, is partnered with the University of Maryland School of Medicine and is recognized regionally and nationally for excellence and innovation in specialized care. Our acute care and specialty rehabilitation hospitals serve urban, suburban and rural communities and are located in 13 counties across the state. For more information, visit www.umms.org.
About CareFirst BlueCross BlueShield
In its 83rd year of service, CareFirst, an independent licensee of the Blue Cross and Blue Shield Association, is a not-for-profit healthcare company which, through its affiliates and subsidiaries, offers a comprehensive portfolio of health insurance products and administrative services to 3.4 million individuals and employers in Maryland, the District of Columbia and Northern Virginia. In 2019, CareFirst invested $43 million to improve overall health, and increase the accessibility, affordability, safety and quality of healthcare throughout its market areas. To learn more about CareFirst BlueCross BlueShield, visit our website at www.carefirst.com and our transforming healthcare page at www.carefirst.com/transformation, or follow us on Facebook, Twitter, LinkedIn or Instagram.
For more information, contact:
CareFirst Media Relations