Frequently Asked Questions
What is Blue Distinction®?
Blue Distinction is a designation awarded by Blue Cross and Blue Shield companies to medical facilities that have demonstrated expertise in delivering quality healthcare. Today, more than 800 Blue Distinction designations in the areas of bariatric surgery, cardiac care, complex and rare cancers, and transplants, have been awarded to more than 650 facilities spanning 45 states.
What is the goal of Blue Distinction?
The goal of Blue Distinction is to help consumers find quality specialty care on a consistent basis, while enabling and encouraging healthcare professionals to improve the overall quality and delivery of care nationwide.
How does Blue Distinction benefit consumers?
Blue Distinction provides consumers with a framework for making informed decisions on where to go for specialty care in the areas of Bariatric Surgery, Cardiac Care, Complex and Rare Cancers, and Transplants. Blue Distinction helps consumers find healthcare facilities that have demonstrated better overall outcomes (e.g., fewer medical complications, fewer readmissions and higher survival rates) in the delivery of specialty care.
How does Blue Distinction benefit the U.S. healthcare system as a whole?
Blue Distinction encourages healthcare professionals and facilities to improve the overall quality and delivery of healthcare, resulting in better overall outcomes for patients. The designation is not exclusionary; rather it recognizes facilities that have met objective selection criteria and have demonstrated consistently better overall results. Through a nationally consistent review process, Blue Distinction offers feedback to facilities that helps to identify opportunities to increase their quality of care.
What are some of the proven outcomes related to Blue Distinction?
Various ongoing analyses illustrate that Blue Distinction Centers are making a difference in patient quality and the cost of services.
A recent study, conducted by HealthCore, Inc., a subsidiary of WellPoint, Inc., confirmed that readmission rates for certain procedures performed at Blue Distinction® Centers for Cardiac CareSM were lower than those performed at other hospitals for Blue Cross Blue Shield patients. Specifically, the study found that patients of the centers experienced:
- 26 percent lower readmission rates for bypass surgery and 37 percent lower for outpatient angioplasty, based on 30-day cardiac-related readmission rates
- 21 percent lower readmission rates for bypass surgery and 32 percent lower for outpatient angioplasty based on 90-day cardiac-related readmission rates
- 5 percent lower costs for bypass procedures and 12 percent lower costs for outpatient angioplasty with a 90-day episode of care
According to BCBSA analyses of hospital RFI response data for 2005, 2006, and 2007 and of data from the Scientific Registry of Transplant Recipients, among Blue Distinction Centers for Transplants®:
The one-year mortality rate for adult heart transplants in Blue Distinction Centers is 11%, compared to 30% in non-Blue Distinction Centers—a significant difference.
According to BCBSA analyses of hospital RFI response data for 2005, 2006, and 2007, among Blue Distinction Centers for Bariatric Surgery®:
The short-term major complication rate among BDCs is 5%, compared to 8% in non-BDCs
What are Blue Distinction's selection criteria requirements?
The designation is based on objective, evidence-based selection criteria. For each specialty area, Blue Cross and Blue Shield collaborates with leading medical organizations and expert physicians to establish criteria based on reviews of peer-reviewed literature, nationally established measures and guidelines, and consensus-driven quality indicators. View a detailed criteria list for each Blue Distinction medical specialty.
What is the re-certification process for Blue Distinction designation?
All facilities must reapply for the designation on a regular basis (typically every 18 - 36 months) to help maintain a consistent focus on quality among facilities that have earned the Blue Distinction designation. These re-evaluation cycles provide an opportunity for Blue Cross and Blue Shield to work with expert physicians and medical organizations to determine if any of our quality criterion should be modified based on updates to clinical evidence or practice guidelines, fostering ongoing opportunities for improving the overall quality of care.
How do consumers find designated Blue Distinction facilities in their area?
Today, there are more than 800 designations among more than 650 facilities nationwide that have been designated as a Blue Distinction Center:
- more than 230 bariatric surgery designations
- more than 410 cardiac care designations
- 90 complex and rare cancers designations
- more than 80 transplants designations
The Blue Distinction Center Finder is available for consumers.
What future specialties will be included in the Blue Distinction designation?
Blue Cross and Blue Shield companies are planning to expand the Blue Distinction designations to include spine surgery, knee and hip replacement surgery, and additional cancer and transplant specialty areas.
What medical organizations does Blue Distinction collaborate with in developing designation programs?
Blue Distinction is committed to collaborating with medical organizations in developing clinical selection criteria for evaluating facilities. Examples of the medical organizations* with whom Blue Distinction has collaborated include:
- Bariatric Surgery: Developed with input from the American Society for Metabolic and Bariatric Surgery and the Surgical Review Corporation.
- Cardiac Care: Developed with input from the American College of Cardiology and the Society of Thoracic Surgeons.
- Complex and Rare Cancers: Developed in strategic collaboration with the National Comprehensive Cancer Network.
- Transplants: Developed with input from the Center for International Blood and Marrow Transplant Research, the Scientific Registry of Transplant Recipients, and the Foundation for the Accreditation of Cellular Therapy.
* These organizations have provided information and input, but do not formally endorse the Blue Distinction Centers® program.
How does Blue Distinction fit into Blue Cross and Blue Shield's vision of healthcare reform?
Blue Distinction Centers meet objective, evidence-based criteria for clinical quality, established in collaboration with expert physicians and medical organizations. The quality designation helps enable consumers to make better-informed decisions in selecting providers, while encouraging improvement in the overall delivery of patient care. Blue Distinction is a key component of Blue Cross and Blue Shield's report entitled, "The Pathway to Covering America," a five-point plan to improve access and healthcare quality.
Visit Blue Distinction for more information.
Note: Designation as Blue Distinction Centers means that these facilities' overall experience and aggregate data met objective criteria established in collaboration with expert clinicians' and leading professional organizations' recommendations. Individual outcomes may vary. To find out which services are covered under your policy at these or any other facilities, please call your local Blue Cross and/or Blue Shield Plan.
