Total Care

Quick reference guide

What is Total Care?

• The industry’s largest national network of value-based care programs – accountable care organizations (ACOs) and patient-centered medical homes (PCMHs), offering coordinated, patient-centered primary care to Blue Cross Blue Shield members across the country.
• Emphasis on prevention, wellness, disease management, and better coordination of care.
• Members can identify and access patient-centered primary care providers managing both quality and cost.

How does Total Care work?

Attribution

• Members attributed to locally developed programs.
• Information exchanged between BCBSA and other Blue Plans.
• Home plans notified when members are attributed to other Plan programs.

Performance-based reimbursement

• Participating providers are reimbursed based on cost and quality.

Member engagement

• Simple tools help members find highperforming providers. Using the provider finder, members can search by Blue Distinction Total Care. Our directory displays the Total Care icon.

The Total Care difference

More than 27 million Blue Cross Blue Shield members receive care through the Total Care program.

Total Care is making health care better and more affordable through data-sharing to more effectively coordinate, manage, and monitor patient care, putting an emphasis on rewarding quality care that leads to better health for patients.

Providers are accountable for managing the care of the patient assigned or “attributed” to them.

The Total Care program has demonstrated measurable improvements in:

• Management of chronic conditions like diabetes and asthma.
• Preventative medicine, including pediatric health screenings and immunizations.

Capital Blue Cross and Total Care

Our provider partners that are part of an Accountable Care Arrangement, Medical Neighborhood or QualityFirst Primary Care Recognition Program (Performance level 2 or 3) are included in the Total Care program.