Total Care

Total Care

Total Care recognizes doctors that focus on health care instead of sick care. These doctors go above and beyond to enhance the overall health of their patients, providing preventive services and wellness coaching, as well as working with patients with chronic conditions to better meet their care needs.

Total Care is coordinated, patient-focused and, in many cases, more affordable health care. Through Total Care, Blue Cross and Blue Shield (BCBS) companies are partnering with doctors and hospitals nationwide to improve health outcomes and curb the rising cost of health care.

Find a Total Care Doctor or Hospital

To find a Total Care doctor or hospital, call the toll-free number on the back of your membership card. To view a list of the Total Care doctors and hospitals in your area, visit the National Doctor & Hospital Finder and choose the Total Care filter in your area.

Coordinated Care for Better Health

As strong patient advocates, Total Care doctors focus on:

  • Helping patients stay healthy through preventive care and wellness programs.
  • Supporting patients in making better health care decisions.
  • Coordinating patients' care across the health care spectrum.
  • Expanding access to primary care through extended office hours and follow-up calls.
  • Reducing or eliminating unnecessary emergency room visits.

Improving Care, Nationwide

Today, over 81 million BCBS members access care through innovative value-based care programs in all 50 states and Washington, D.C., with more than 654,000 providers participating1.

Total Care is part of BCBS companies' continued leadership in the shift to patient-focused, value-based care models. Currently, over 31 million BCBS members receive care from Total Care designated providers, enhancing their health care experience and quality of life2.

9.4%
fewer emergency visits
6%
higher immunization rates
3.3%
better comprehensive diabetes care

Total Care Overview

A New Standard

Total Care is the nation’s largest network of value-based programs—accountable care organizations (ACOs) and patient-centered medical homes (PCMHs)—that reward quality of care instead of quantity. Participating providers are focused on better care coordination, chronic condition management, prevention and wellness to help members stay healthy and out of the hospital.

Increasing Quality and Better Outcomes

Through Total Care, we are achieving measurable improvements by coordinating care more effectively. We are dedicated to keeping patients healthy with preventive care and wellness programs, and we support patients in making better health care decisions. Our Total Care providers focus on:

  • Expanding access to primary care by extending alternative sites of care.
  • Limiting unnecessary medical treatment and services.
  • Managing chronic disease, like diabetes, asthma and cardiovascular disease.
  • Focusing on regular screenings and immunizations.

Overall, Total Care participating providers perform better at closing quality measure gaps and managing patient’s health care needs over time.

Eligibility and Evaluation

Primary care doctors, medical practices and hospitals can be considered for the Total Care designation. BCBS companies nationwide use the following criteria to evaluate doctors and hospitals for Total Care:

  • Doctors and hospitals have established quality and cost targets and are paid by BCBS companies, at least in part, based on meeting these targets to deliver higher quality, more affordable care to their patients.
  • Doctors and hospitals must use data and analytics to better understand and improve their medical practices.
  • The programs offered by these doctors and hospitals must have broad availability for BCBS members.
1 2022 Value-Based Program Topline National Statistics, released October 2023.
2 2019 Total Care National Aggregate Results, released December 2021, evaluation of BCBS claims from 2018-2019.