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Blue Distinction for Providers

The Blue Distinction Specialty Care Program is a national designation program that recognizes hospitals that demonstrate expertise in delivering quality specialty care — safely, effectively, and cost efficiently. The program is expanding its historic focus on quality of care to include a designation that also considers the cost of care. The result:

Blue Distinction Centers and Blue Distinction Centers+ are designed to recognize hospitals delivering the following types of specialty care:

If you would like for your hospital to be considered for any of the six separate Blue Distinction designations, please contact your local Blue Plan for more details.

Blue Distinction Centers for Bariatric Surgery

Blue Distinction Centers Bariatric Surgery provide a full range of bariatric surgical care services including inpatient care, post-operative care, follow-up and patient education. These facilities must meet stringent quality criteria, as established by expert physician panels, surgeons, behaviorists and nutritionists.

Current Designation Materials (Blue Distinction Centers and Blue Distinction Centers+ designations - 2014/2015)

Previous Designation Materials (Blue Distinction Centers designations - 2010)

Blue Distinction Centers for Cardiac Care

Blue Distinction Centers and Blue Distinction Centers+ for Cardiac Care are medical facilities with demonstrated expertise and a commitment to quality care, resulting in better overall outcomes for cardiac care patients, including cardiac cares services and, in the case of Blue Distinction Centers+, efficiency.

Blue Distinction Centers and Blue Distinction Centers+ for Cardiac Care are medical facilities with demonstrated expertise and a commitment to quality care, resulting in better overall outcomes for patients of seeking inpatient cardiac care services, including, cardiac rehabilitation, cardiac catheterization and cardiac surgery (including coronary artery bypass graft surgery) and in the case of Blue Distinction Centers+, efficiency.

Current Designation Materials (Blue Distinction Centers and Blue Distinction Centers+ designations)

Blue Distinction Centers for Complex and Rare Cancers

Blue Distinction Centers Complex and Rare Cancers have received their designation based on surgical case volume for adults with certain complex and rare cancers, as well as structure and process criteria. There is evidence supporting that for many complex and rare cancers, higher surgical volume is related to improved patient outcomes. Our first phase of the program assesses facilities on evaluation, treatment planning, complex inpatient care and major surgical treatments; all delivered by multidisciplinary teams with distinguished expertise and subspecialty training for complex and rare cancers.

While this designation is meant as a comprehensive indicator of quality, facilities were required to submit data on each of the individual cancer types as part of the evaluation process. The cancers were split into two groups based on the strength of available evidence and, to a lesser extent, rarity of the cancer type. The cancer types with stronger evidence were weighed more heavily during the evaluation process.

To become a Blue Distinction Center Complex and Rare Cancers, facilities had to satisfy criteria for at least five of the eight main cancers. The additional cancer types were also evaluated and are intended to be another resource for patients and providers. Each cancer type, regardless of group, had three criteria areas that had to be met for an applicant to satisfy qualifications:

  1. Multidisciplinary treatment team and corresponding sub-specialty training (varied by type)
  2. Regular meetings of sub-specialized, multidisciplinary tumor board/cancer conferences
  3. Minimum annual average surgical case volume

Main cancers used for this designation evaluation:

  • Bladder cancer
  • Brain cancer – primary
  • Esophageal cancer
  • Gastric cancer
  • Liver cancer – primary
  • Pancreatic cancer
  • Rectal cancer
  • Acute leukemia (inpatient, non-surgical)

Additional cancers:

  • Bone cancer – primary
  • Head and neck cancers
  • Ocular melanoma
  • Soft tissue sarcoma
  • Thyroid cancer – medullary or anaplastic

The evidence-based selection criteria for this program were developed in strategic collaboration with the National Comprehensive Cancer Network (NCCN)*, and a panel of expert clinicians.

Blue Cross and Blue Shield recognizes that the majority of patients' multidisciplinary treatment may be best accomplished by integrating the expertise available in a Blue Distinction Center® with locally available treatment resources, especially for outpatient chemotherapy and radiotherapy, based on individual circumstances and patient preference. Optimal support of a patient's comprehensive cancer care needs may be achieved by coordination of care between the patient and their family, local physicians, the Blue Distinction Center and their local Blue Cross and Blue Shield company.

* This organization has provided information and input, but does not formally endorse the Blue Distinction Centers program.  

Blue Distinction Centers for Knee and Hip Replacement

Blue Distinction Centers and Blue Distinction Centers+ for Knee and Hip Replacement are medical facilities with demonstrated expertise and a commitment to quality care, resulting in better overall outcomes for patients of comprehensive inpatient knee and hip replacement services, including total knee replacement and total hip replacement and, in the case of Blue Distinction Centers+, efficiency.

Current Designation Materials (Blue Distinction Centers and Blue Distinction Centers+ designations)

 

Blue Distinction Centers for Spine Surgery

Blue Distinction Centers and Blue Distinction Centers+ for Spine Surgery are medical facilities with demonstrated expertise and a commitment to quality care, resulting in better overall outcomes for patients of seeking inpatient spine surgery services, including discectomy, fusion and decompression procedures and, in the case of Blue Distinction Centers+, efficiency.

Current Designation Materials (Blue Distinction Centers and Blue Distinction Centers+)

 

Blue Distinction Centers for Transplants

The Blue Distinction Centers for Transplants® consist of a national network of transplant centers that offer comprehensive services through a coordinated, streamlined referral management. All of the Blue Distinction Centers for Transplants meet specific program selection criteria that consider not only provider qualifications and program process, but patient outcomes as well.

The Blue Distinction Centers for Transplants program examines the following transplant types:

  • heart
  • lung (single or bilateral) 
  • combination heart/lung
  • liver (deceased and living donor)
  • simultaneous pancreas kidney (SPK)
  • pancreas (PAK/PTA)
  • bone marrow/stem cell (autologous & allogeneic)

Current Designation Materials (Blue Distinction Centers and Blue Distinction Centers+ designations - 2012/2013)

Previous Designation Materials (Blue Distinction Centers designations - 2010)

Click here for additional resources and facts about transplant services.


Blue Distinction® Centers met overall quality measures for patient safety and outcomes, developed with input from the medical community. Blue Distinction® Centers+ also met cost measures that address consumers’ need for affordable healthcare. Individual outcomes may vary. National criteria is displayed on www.bcbs.com. A Local Blue Plan may require additional criteria for facilities located in its own service area. To find out which services and providers (including hospital based physicians) are covered under your policy, or to learn about Local Blue Plan Criteria, contact your Local Blue Plan; and contact your provider before making an appointment to verify its current Network and Blue Distinction Centers status. Each hospital’s Cost Index is calculated separately, based on data from its Local Blue Plan. Hospitals in portions of CA, ID, NY, PA, and WA may lie in areas served by two Local Blue Plans, resulting in two Cost Index figures; and their own Local Blue Plans decide whether all hospitals in these areas must meet Blue Distinction Centers+ national criteria for one or both Cost Index figures. Neither Blue Cross and Blue Shield Association nor any Blue Plans are responsible for damages, losses, or non-covered charges resulting from Blue Distinction or other provider finder information or care received from Blue Distinction or other providers. To find out more, contact your Local Blue Plan.