Table 1.

Summary of Patient-Centered Medical Home Requirements

1.PCPs and NPs are required to be in good standing in CareFirst's regional PPO and HMO networks, abide by program rules (in Program Description and Guidelines), form or become part of a medical care panel, and become engaged in the care coordination activities at the heart of the program.
2.A PCP is eligible for the PCMH program if he or she is a health care provider who is full time, a duly licensed medical practitioner, is a participating provider, and contracted to render primary care services in both the CareFirst BlueChoice Participating Provider Network (HMO) and the CareFirst Regional Participating Network and has a primary specialty in on the following: internal medicine, family practice, general practice, pediatrics, geriatrics, family practice/geriatric medicine, osteopathic medicine (primary care), or NPs (primary care).
3.All PCPs in a group practice must join the program or none are accepted.
4.Panels must contain at least a minimum of 5 PCPs and/or NPs.
5.Practices may not participate in another PCMH during the time of CareFirst PCMH participation if both programs provide fees or incentives to the practice or CareFirst member.
  • HMO, health maintenance organization; NP, nurse practitioner; PCMH, patient-centered medical home; PCP, Primary care physician; PPO, preferred provider organization.