Disease Management

Behavioral Health and Substance Use

To support your behavioral health treatment recommendations and plans of care, CareFirst provides several programs to help meet the specific needs of your patients, including:

  • Intake, Assessment and Appointment Team
    • Representatives who help patients find the right behavioral health provider for their situation and location, schedules the appointment and follows-up after the appointment.
    • Members should call 1-800-245-7013.
  • Behavioral Health and Substance Use Disorder Program
    • For patients with conditions like depression, autism spectrum disorder, or anxiety, this program provides one-on-one support through a specialty-trained and licensed behavioral health care coordinator.

      Learn more about the program.
    • For patients struggling specifically with addiction or substance use, CareFirst offers trusted providers within outpatient addiction recovery centers who can provide treatment and care options, support groups, and education.

      Learn more about the Substance Use Disorder Program.

Support is available today. Call CareFirst at 1-800-245-7013.

Diabetes

CareFirst offers several personalized programs to help our members who are at-risk for or already living with diabetes. These programs are part of their benefits and available at no additional cost.

Scale Back Program

This program is designed to help CareFirst patients at risk for prediabetes. Scale Back is an interactive, telehealth-based weight loss program offered through our wellness partner, Sharecare, Inc.* This 12-month program helps patients lose 5–10% of their body weight and significantly reduce their risk of developing type 2 diabetes. The Scale Back program includes:

  • 26 interactive lessons
  • Support and guidance from a personal health coach
  • Tools and resources for their weight loss success—including a free digital scale
  • Encouragement from fellow group members

Patients who fully participate in two sessions over four weeks can receive a free Fitbit to help track their physical activity, sleep patterns and more.

Refer CareFirst patients to carefirst.com/sharecare to create an account. Patients should then navigate to the Achieve section, select Programs, then click Scale Back for a short assessment.

Diabetes Management Coaching Program

This program, offered through our wellness partner, Sharecare, Inc.* features one-on-one phone-based coaching sessions with a registered nurse specially trained to support patients with type 1 or type 2 diabetes. The type of support patients can receive include:

  • Personalized counseling
  • Educational materials
  • Online tools

CareFirst patients interested in learning about or joining the coaching program can call 877-260-3253 and press option 7.

Diabetes Virtual Care Program

This program offers support for patients who need help stabilizing their type 2 diabetes. Offered by CareFirst, along with Onduo**, a leading diabetes management company, this program provides patients with personalized support, easy-to-use tools and access to certified diabetes educators through a mobile app.

The program offers patients with the care and support they may need between doctor visits such as:

  • Testing supplies and connected devices—patients will receive a welcome kit with a connected blood glucose meter and unlimited test strips shipped right to their door.
  • Personalized one-on-one virtual coaching—patients can also chat with their personal care lead to set up a plan to improve nutrition, start an exercise program, or meet a health goal.
  • Virtual doctor visits—patients can schedule a telehealth visit with an endocrinologist or certified diabetes educator, as needed, to receive personal recommendations and guidance to manage any symptoms. Onduo will help patients coordinate information with their doctor.

Refer today. Patients may self-enroll in the Diabetes Virtual Care program by visiting Onduo.com/CareFirstRefer.

* This wellness program is administered by Sharecare, Inc., an independent company that provides health improvement management services to CareFirst members. Sharecare, Inc. does not provide CareFirst BlueCross BlueShield products or services and is solely responsible for the health improvement management services it provides.

** This program is provided by Onduo, LLC an independent company that does not provide Blue Cross Blue Shield products or services.

Heart Disease

CareFirst offers a free, comprehensive disease management program for members who have or are at risk for congestive heart failure (CHF) and coronary artery disease (CAD). This confidential, voluntary program:

  • provides routine updates to keep physicians informed about patients' progress and adherence to the plan of care 
  • takes note of the high rate of heart disease among persons with diabetes 
  • reinforces the physician's plan of care 
  • is administered by Healthways, Inc. 

Eligible members:

  • can reach a nurse by phone 24 hours a day 
  • are assigned a nurse care manager (if greater disease severity exists) 
  • receive educational materials, including condition-specific workbooks, action plans and newsletters. 

To obtain more information, refer a patient or if you are a member and want to self-refer, please call the CHF/CAD management program at (800) 783-4582.

CareFirst supports the American Heart Association Clinical Guidelines. You may obtain a copy of these guidelines at www.americanheart.org

Oncology

CareFirst's cancer management program seeks to ensure the best possible outcomes for members with cancer.

Enrolled members are assigned to an experienced oncology Care Manager, who:

  • monitors their progress in conjunction with the physician's plan of care 
  • provides educational and emotional support 
  • is available by calling (888) 264-8648 Monday - Friday from 8:30 a.m. to 4:30 p.m. 

Providers may refer a member to the oncology program by calling (888) 264-8648.

Respiratory Diseases

CareFirst offers free, comprehensive disease management programs for members with asthma and chronic obstructive pulmonary disease (COPD). These confidential, voluntary programs:

  • help members learn how to self-manage their condition
  • reinforce the physician's plan of care
  • are administered by Healthways, Inc.

Enrolled members:

  • can access a nurse by phone 24 hours a day, 7 days a week
  • are assigned a nurse care manager, if disease is severe
  • receive educational materials, including condition-specific workbooks, action plans and newsletters.

To obtain more information, refer a patient or if you are a member and want to self-refer, please call the Asthma Management Program at (800) 783-4582.