CareFirst BlueCross BlueShield and Children’s National Hospital Expand Access to Mental Health and Chronic Condition Support for Kids

Effort is part of a new, unique alliance between the healthcare organizations to help meet community needs through value-based care and community health interventions

Washington D.C., May 01, 2024 (GLOBE NEWSWIRE) -- Today, CareFirst BlueCross BlueShield (CareFirst), one of the largest not-for-profit healthcare organizations in the nation, and Children’s National Hospital, a top-ranked children’s hospital located in Washington, D.C., announced a new alliance that’s taking a unique approach to help address the youth mental health crisis and improve health outcomes.   

As part of this alliance, CareFirst has increased the reimbursement for preventive and mental health care for primary care providers who go through specialized mental health training focused on depression, suicide prevention, anxiety, ADHD and eating disorders. The training is offered through the Pediatric Health Network, the clinically integrated network of healthcare providers for Children’s National, to its more than 1,500 members including more than 700 primary care physicians.   

In 2021, U.S. Surgeon General Dr. Vivek Murthy issued an advisory detailing an urgent youth mental health crisis. Unfortunately, access to pediatric mental health care is a national challenge, and for children and families, timely and effective support can be elusive. Empowering primary care providers with specialized training will help break down barriers and reshape care delivery.  

“Providers face challenges due to limited resources and insufficient support in addressing 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,” says Nathaniel Beers, M.D., executive vice president for Community and Population Health for Children’s National Hospital. “With these trainings, our providers gain the knowledge, tools and confidence to handle sensitive conversations, offer vital support and make informed referrals when needed."  
The alliance executes a value-based care payment model for the Children’s National network of community physicians, enhancing benefits to offer more value to physicians and patients while aiming to drive improved outcomes, patient experience and coordination in care. By embedding mental health care within the familiar confines of primary care settings, this initiative ensures children receive timely interventions in an environment they trust.  
This work to improve access to mental health services is just one part of the broader unique payer-provider alliance between CareFirst and Children’s National to address healthcare disparities and social determinants of health. Targeted pediatric interventions are set upon three pillars:   

    • Value-based care  
    • Community health initiatives  
    • Member benefit enhancements   

Each pillar is delivered and informed by experts from both organizations with distinct tactics and funding designed for three key priority health conditions:   

    • Behavioral and mental health  
    • Diabetes  
    • Infant mortality  

“As the lines continue to blur between payers and providers, with vertical integration and the reimbursement shift from volume to value, insurers and hospitals need to continue to evolve their relationships with each other,” said Brian Wheeler, executive vice president of Health Services for CareFirst. “This model aims to address the need for affordable healthcare, employing a patient-centric approach that encourages seamless treatment for the patient and provider.”   

The next major program in development is focused on improving diabetes care through early diagnosis to lessen vulnerability and severity and improve long-term positive health outcomes.  Community health initiatives will continue to be developed through the Children’s National Child Health Advocacy Institute and Community Health programs with the support of CareFirst’s philanthropic efforts.   
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About CareFirst BlueCross BlueShield  
In its 86th 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 3.5 million individuals and employers in Maryland, the District of Columbia and Northern Virginia. In 2023, CareFirst infused $233 million in support of regional community impact to improve overall health and advance accessible, affordable, equitable, high-quality healthcare. To learn more about CareFirst BlueCross BlueShield, visit    
About Children's National Hospital  
Children’s National Hospital, based in Washington, D.C., was established in 1870 to help every child grow up stronger. Today, it is the No. 5 children’s hospital in the nation and ranked in all specialties evaluated by U.S. News & World Report. Children’s National is transforming pediatric medicine for all children. The Children’s National Research & Innovation Campus opened in 2021, a first-of-its-kind pediatric hub dedicated to developing new and better ways to care for kids. Children’s National has been designated three times in a row as a Magnet® hospital, demonstrating the highest standards of nursing and patient care delivery. This pediatric academic health system offers expert care through a convenient, community-based primary care network and specialty care locations in the D.C. metropolitan area, including Maryland and Virginia. Children’s National is home to the Children’s National Research Institute and Sheikh Zayed Institute for Pediatric Surgical Innovation. It is recognized for its expertise and innovation in pediatric care and as a strong voice for children through advocacy at the local, regional and national levels. As a non-profit, Children's National relies on generous donors to help ensure that every child receives the care they need. For more information, follow us on Facebook, Instagram, Twitter, andLinkedIn.  


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