Maryland Payer, Provider Creating Combined Population Health Management Team

Oct. 15, 2020
CareFirst BlueCross BlueShield acquisition of UMMS health plans is catalyst for new partnership

In a partnership deal spurred by acquisitions, CareFirst BlueCross BlueShield  and the University of Maryland Medical System (UMMS) are creating a jointly operated population health management team, which will allow UMMS and CareFirst to collaborate on innovative care models. 

Baltimore-based CareFirst, the region’s largest not-for-profit healthcare company, and UMMS, a university-based regional health system, announced a five-year partnership to address access and quality of care for the state’s most vulnerable populations. CareFirst BlueChoice Inc. will acquire University of Maryland Health Advantage Inc. (UM Health Advantage), a Medicare dual eligible special needs health plan, and University of Maryland Health Partners Inc., a Medicaid managed care organization. Combined, UMMS’ Health Plans serve 55,000 Maryland residents each year.

At the core of this partnership, the organizations say, 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. 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. CareFirst and UMMS say that the joint effort allows them 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.  The hope is that this will result in better performance on clinical, quality, affordability and patient experience measures for all populations served by both organizations. 

“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,” said Mohan Suntha, M.D., M.B.A., president and CEO of UMMS, in a statement. “The deepening of our longstanding partnership with CareFirst opens up exciting new possibilities to better serve our communities’ vulnerable populations together.”

Finalizing the acquisition and rebranding of health plans will be subject to regulatory approval as well as the consent of the Centers for Medicare & Medicaid Services and the State of Maryland.

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