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CareFirst weighs rejoining Medicaid, Medicare Advantage markets after nearly 20-year absence

CareFirst BlueCross BlueShield may begin offering Medicaid and Medicare Advantage options to regional consumers as soon as 2021, after being absent from the markets for nearly two decades.

Following major financial losses, CareFirst announced in July 2000 it was bowing out of the state Medicaid managed care and Medicare HMO markets. The region’s largest health insurer reported losing close to $20 million in 2000 on reimbursement from the two programs. About 88,000 Maryland Medicare and Medicaid members, many of them in rural areas, lost coverage as a result of the decision, which drew some ire from state legislators.

But CareFirst’s new CEO Brian Pieninck said he thinks it is time for the not-for-profit carrier, which has long touted itself as a mission-driven health care company, to get back into those markets. He sees it as a responsibility of CareFirst to offer its roughly 3 million regional members a “full continuum” of health options throughout their lives.

“We have two substantial…

Read the full story from the Washington Business Journal.



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