CommercialReimbursementMedium impact
Official Outcome Incentive Award Performance and Participation Fee Notice (Aug. 1, 2025)
CareFirst BlueCross BlueShield·Family Medicine, Internal Medicine, General Practice +1 more·Provider News
Effective date
Aug 1, 2025
We identified it
Jun 20, 2026
Summary
CareFirst BlueCross BlueShield has released 2024 Outcome Incentive Awards (OIAs) for their Patient-Centered Medical Home (PCMH) Program, effective August 1, 2025 through July 31, 2026. Primary care providers can view their performance-based incentive awards and updated fee schedules through the SearchLight portal, with approximately 50% of eligible panels achieving cost savings below expected targets.
Action Required
By May 31, 2025: Primary care providers participating in CareFirst PCMH Program should log into SearchLight portal through Provider Portal to view 2024 OIA results and updated fee schedules. Billing team must review fee schedule updates effective August 1, 2025 and update billing system with new reimbursement rates. Ensure practice maintains engagement requirements and achieves 65% of quality scorecard points to avoid losing participation fees.