CareFirst BlueCross BlueShield Opens Networks and Primary Care Medical Home Program to Nurse Practitioners

Baltimore, Maryland (November 4, 2010) - CareFirst BlueCross BlueShield (CareFirst) today announced that, effective immediately, it will permit nurse practitioners (NPs) to participate in its health care provider networks as independent primary care providers. Previously, CareFirst permitted NPs to participate in its networks, but they were only permitted to practice independently of physicians in certain medically underserved areas with limited access to primary care physicians.

"Federal health care reforms will over the next few years result in more residents of our region being covered by health insurance, and that will increase demand for primary care services," said Bruce Edwards, CareFirst Senior Vice President for Networks Management. "In addition, CareFirst is placing an increased emphasis on primary care through our Primary Care Medical Home Program (PCMH), which will launch in January 2011. With these developments ahead and an existing need to expand access to these services, allowing nurse practitioners to practice independently as primary care providers is a logical move to serve our members better."

More physicians, nurses and other medical professionals will be necessary to care for the 32 million additional Americans expected to be covered by 2014 under the federal health care reform law. In fact, the Association of American Medical Colleges projects that, by 2015, there will be a shortage of nearly 63,000 doctors across all medical specialties nationwide.

Under CareFirst's revised policy, NPs may enroll in its provider networks to serve as independent primary care providers throughout the company's Maryland, Northern Virginia and District of Columbia service area. NPs will have to meet CareFirst credentialing criteria, be certified by their relevant approved National Certification Board, and meet all of the licensing/certification guidelines of the state in which the NP practices. In addition, the NP must attest that they have a written collaborative agreement with a physician of the same specialty who is a member in good standing of the same CareFirst provider networks as the NP. Similarly, NPs who meet network participation criteria will be able to participate with primary care physicians as part of a medical panel or form their own medical panels as part of CareFirst's PCMH.

In its 74th year, CareFirst, an independent licensee of the Blue Cross and Blue Shield Association, is a not-for-profit health care organization which, through its affiliates and subsidiaries, offers a comprehensive portfolio of health insurance products and administrative services to nearly 3.4 million individuals and groups in Maryland, the District of Columbia and Northern Virginia. Through its CareFirst Commitment initiative and other public mission activities, CareFirst supports efforts to increase the accessibility, affordability, safety and quality of health care throughout its market areas. To learn more about CareFirst BlueCross BlueShield, visit our Web site at