Washington, DC

by Prince Of Petworth October 31, 2018 at 1:45 pm 0

To say folks were bummed about the One Medical CareFirst split would be a slight understatement. Folks were furious. Perhaps there is some light. A reader writes her benefits rep:

“Can you please confirm for me that One Medical WILL be in-network for CareFirst, and the date that will be effective?”

The replied:

“It’s my understanding, the contract with One Medical begins on January 1.”

And it’s official:

by Prince Of Petworth December 11, 2017 at 2:30 pm 0

Thanks to a reader for sending this “CareFirst Statement on One Medical Group”:

“In September, One Medical Group (One Medical) notified CareFirst of its intention to terminate its agreement as a CareFirst participating provider effective December 18, 2017 if no agreement could be reached by CareFirst and One Medical on future reimbursements. Unfortunately, an agreement has not been reached and One Medical will no longer be a participating provider as of December 18.

CareFirst members who have selected One Medical as their primary care provider or who have utilized One Medical services will receive additional information in the mail. If you need assistance selecting an in-network primary care provider or have questions about an ongoing course of care you or a family member are currently receiving through a One Medical provider, call the Member Service telephone number listed on your ID card.”

by Prince Of Petworth December 1, 2017 at 1:15 pm 0

“Dear PoPville,

Thanks for your previous coverage of the One Medical/Blue Cross Blue Shield debacle. I’m a government employee who has been using One Medical for years now and I don’t plan to switch providers, which means I need to find new insurance. I’m wondering if any of your other readers are experiencing the same problem and have recommendations for alternative coverage that is accepted by One Medical. I’ve been looking at plan brochures for the last couple of hours and I’m starting to drive myself crazy trying to compare all the available plans. Any advice or insight from other readers would be appreciated. Thanks!”

Thanks to Liz for sending me the above message she received this morning from Medical One.

Emily notes: “half of my office is scrambling to get a new provider”

by Prince Of Petworth October 25, 2017 at 11:15 am 0

Thanks to Scott sending:

“I just asked One Medical to respond to the Carefirst claims and this is what I got back:

Unlike larger health systems, One Medical is focused exclusively on primary care because we know it is an essential part of bringing down overall healthcare costs.

Because they treat many of their needs in the primary care setting, One Medical patients save more than the average patient by reducing unnecessary emergency room or specialty visits.

Even a meaningful increase to our reimbursement rates does not bring us into the top percentage of medical practices in the DC area.

Our goal is to build a practice that is sustainable and strong. We cannot do this without fair and equitable payment rates from our insurance partners. We believe that the rates we seek will simply get us to a fair rate for the quality, service-oriented care we provide–nothing more. (more…)

by Prince Of Petworth October 24, 2017 at 10:55 am 0


1827 Adams Mill Road, NW

Thanks to Alta (and others) for sending: “FYI – CareFirst dropped this on Friday”

Dear Member:

As you may know, CareFirst BlueCross BlueShield and CareFirst BlueChoice, Inc. (collectively, “CareFirst”) has received notice from One Medical that it plans to unilaterally terminate its agreement to participate as a network provider with CareFirst effective December 18, 2017.

What Happened?

One Medical and CareFirst have worked closely together since One Medical began its practice in the region in 2011. For example, One Medical has been deeply involved in our Patient-Centered Medical Home Program (PCMH) in a collaboration with CareFirst toward better quality and cost results and has earned substantial financial incentives as a result. Hence, the termination notice was unexpected and follows a recent national leadership change at One Medical.

One Medical’s new national leadership has made two demands in seeking to terminate its contract with CareFirst: (more…)

by Prince Of Petworth October 5, 2017 at 9:50 am 0


1827 Adams Mill Road, NW

Thanks to Alex for sending CareFirst’s response to the One Medical coverage situation:

“One Medical is seeking dramatic – egregious – increases in rates from CareFirst as well as additional mandatory charges from CareFirst members that would result in millions of dollars in additional costs to members. Such cost increases at a time when many are already struggling to pay for their healthcare are unconscionable. The sharply increased rates and fees One Medical seeks ultimately come directly out of the pockets of our members and the employer groups to which they belong and these costs have become harder and harder to bear.

The out of network status that One Medical seeks will place their service beyond the reach of many members. This will likely necessitate the need for members who use One Medical to re-establish their primary care relationships with other practices. We deeply regret this unilateral decision by One Medical. However, discussions to resolve this will continue.”

by Prince Of Petworth October 4, 2017 at 3:15 pm 0


1827 Adams Mill Road, NW

And the people are not pleased. Holy smokes thanks to all for messaging us about One Medical:

“We want you to know about some important changes regarding your CareFirst BlueCross BlueShield coverage.

Beginning December 18, 2017, One Medical will no longer be an in-network provider through CareFirst. Please contact us at 202.204.7440 or [email protected] for additional details. We’re here to help you understand what these changes may mean for you and to offer options that allow you to continue your care with One Medical.

Sincerely,
The One Medical Team”

Update: Another reader writes:

[email protected]

This is where people can complain!”

by PoP Sponsor February 26, 2018 at 4:30 pm 0

The current state of primary care in the District isn’t pretty.

On average, it takes 17 days to get an appointment with a family physician. Between 2010 and 2014, the number of primary care providers in DC dropped nearly 15 percent. And with continued instability and increasing healthcare costs, primary care’s focus on preventive care and identifying problems before they’re big is more important now than ever. 

But with good primary care so hard to find, how do you know what to look for?

“We all need a health sherpa to guide us through the medical (and non-medical) bumps in life,” said Casey O’Bryan, FNP, a primary care provider at One Medical’s Dupont Circle office. “Establishing a relationship with a primary care provider should be an extra force field of goodness and reliability in a turbulent, internet-rabbit-hole world.”

“Primary care is more than just an annual physical. It’s your medical home,” said Julia Lim, MD, from One Medical Tysons.

Essentially, quality primary care becomes the hub for everything related to your health, with your primary care provider, or PCP, guiding you through it all. That means your PCP becomes an expert in you and your health goals, listening, translating test results and working with other medical professionals to make sure you’re getting better — your partner in health.  

“When you have a trusting relationship with your PCP, you’re more likely to be honest about your health concerns and lifestyle,” added Amy Stulman, NP, from One Medical Union Station. “And providers who know their patients well are better equipped to offer individualized care and health recommendations.”

“It can be challenging in DC to find those qualities in a health practice that is also accessible and timely,” Lim said, “and One Medical can do just that. With same- and next-day appointments, you can get care when you actually need it from a provider who knows you.” 

Book your appointment at one of our six DC area offices today.

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