CareFirst BlueCross BlueShield and Children’s National Hospital in Washington, DC, have entered into a value-based care alliance to address three key priority health conditions: mental and behavioral health, diabetes, and infant mortality.
The first initiative involves addressing the youth mental health crisis. As part of this partnership, the nonprofit CareFirst has increased reimbursement for preventive and mental health care for primary care providers who receive specialized mental health training focused on depression, suicide prevention, anxiety, ADHD and eating disorders. The training is offered through Pediatric Health Network, Children’s National’s clinically integrated network of healthcare providers, to its more than 1,500 members, including more than 700 primary care physicians.
“Providers face challenges due to limited resources and insufficient support to address pediatric mental health needs. CareFirst’s commitment to increasing reimbursement for mental health care underscores the integral role of primary care providers in this space,” Nathaniel Beers, MD, executive vice president of Community and Population Health at Children’s National Hospital, says in a statement. “With these trainings, our providers gain the knowledge, tools and confidence to handle sensitive conversations, offer vital support and make informed referrals when necessary.”
Alliance executes a value-based care payment model for Children’s National’s community physician network, enhancing benefits to deliver more value to physicians and patients while aiming to drive improved outcomes, patient experience and coordination in attention. By integrating mental health care within the familiar boundaries of primary care settings, this initiative seeks to ensure that children receive timely interventions in an environment they trust.
CareFirst and Children’s National said these pediatric-specific interventions are built on three pillars: value-based care, community health initiatives and member benefit improvements. “As the lines between payers and providers continue to blur, with vertical integration and reimbursement shifting from volume to value, insurers and hospitals must continue to evolve their relationships with each other,” said Brian Wheeler, executive vice president of Health Services. of CareFirst, in a statement. “This model aims to address the need for affordable healthcare, employing a patient-centered approach that encourages seamless treatment for the patient and provider.”
The next major program in development focuses on improving diabetes care through early diagnosis to reduce vulnerability and severity and improve long-term positive health outcomes. Community health initiatives will continue to be developed through the National Advocacy Institute for Children’s Health and Community Health programs with support from CareFirst’s philanthropic efforts.
