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April 2023

2023 brings changes to Total Care Program

Beginning April 7, 2023, Blue Cross Blue Shield of Michigan will be removing Organized Systems of Care from the national Total Care Program as the OSC program no longer offers the incentives required to meet Total Care’s current value-based reimbursement structure.

Total Care is a national designation program that recognizes doctors and hospitals for their efforts in coordinating total patient care, emphasizing prevention and wellness, and helping patients better manage chronic conditions to improve patient outcomes and cost-efficiency. Total Care providers are paid with value-based reimbursement rather than traditional fee-for-service, so they perform against both quality and cost outcome targets to receive incentives and rewards for better health outcomes.

About Organized Systems of Care

An OSC is a community of caregivers that has responsibility for a specific patient population. Blue Cross’ OSC program was initially introduced as an expansion of our Patient-Centered Medical Home program.

If you have any questions about this change, contact Lindsey Novach of National Programs at LNovach@bcbsm.com.

No portion of this publication may be copied without the express written permission of Blue Cross Blue Shield of Michigan, except that BCBSM participating health care providers may make copies for their personal use. In no event may any portion of this publication be copied or reprinted and used for commercial purposes by any party other than BCBSM.

*CPT codes, descriptions and two-digit numeric modifiers only are copyright 2022 American Medical Association. All rights reserved.