Through Total Care, Blue Cross and Blue Shield companies are partnering with doctors and hospitals nationwide to improve health outcomes for your employees and curb the rising cost of healthcare.

Better quality

  • 3% better use of appropriate imaging services
  • 4% better comprehensive diabetes care
  • 6% better breast cancer screening rates
  • 10% fewer emergency room visits

Lower Cost

Total Care is reducing overall healthcare cost trend for our customers by more than 30%

 

Results reflect an evaluation of BCBS claims from 2017 to 2018, comparing Total Care providers to non-Total Care. Source: TC Evaluation 5.0 National Aggregate Results, April 2020.

Doctor and patient

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 your employees stay healthy and out of the hospital.

19+ million bcbs members have access to total care

156,000+ providers participating

Available in 95 of the top 100 metropolitan areas

 

Total Care is part of Blue Cross and Blue Shield (BCBS) companies’ continued leadership in the shift to patient-focused, value-based care models. The BCBS System’s full portfolio of value-based care programs includes ACOs, PCMHs, pay-for-performance programs and episode-based payment programs, all aimed at rewarding quality care that leads to better health for patients. Today, nearly 62 million BCBS members have access to care through these innovative care programs across all 50 states and Washington, D.C.

Measuring Quality Performance

BCBS companies rely on nationally consistent, industry-standard measures to monitor the performance of Total Care providers. Total Care measures are aligned with the ACO and PCMH core quality measure set established by America’s Health Insurance Plans (AHIP) and the Centers for Medicare and Medicaid Services (CMS), and uses Healthcare Effectiveness Data and Information Set (HEDIS) utilization measures from the National Committee for Quality Assurance (NCQA).

Total Care is showing higher performance in 22 out of 23 (96%) key measures nationally — equating to a better healthcare experience and quality of life for employees.


Source: BDTC Evaluation 3.0 – National Aggregate Results, January 2018

FOR YOUR BUSINESS

Talk with your BCBS representative, consultant or broker, or get in touch with your local Blue Cross Blue Shield company to learn more.

The Blue Cross Blue Shield Association is an association of 35 independent, locally operated Blue Cross and/or Blue Shield companies.