A Better Healthcare System for the Future
Blue Distinction® is an innovative new program Blue Cross and Blue Shield companies created to help bring about a better healthcare system for future generations. The kind of future healthcare system envisioned by Blue Cross and Blue Shield is embodied in The Pathway to Covering America, a comprehensive plan to improve healthcare quality and affordability — and extend health insurance to every American.
About Blue Distinction
Armed with a commitment to evidence-based medicine and nationally established quality measures — Blue Cross and Blue Shield companies are collaborating with expert physicians and medical organizations* to improve the quality of care across America. A key part of achieving this objective rests with changing incentives in our healthcare system to reward quality of care and better patient outcomes — another key tenet in The Pathway to Covering America. The incentives in our system must be changed to reward providers for delivering the best quality care, not just more services.
On behalf of the Blue Cross and Blue Shield companies, Blue Distinction evaluates programs based on objective, evidence-based criteria and designates those that meet stringent quality criteria as Blue Distinction Centers for Specialty Care®. The program is designed to empower consumers to make informed decisions in selecting providers, and also encourages better quality care.
Blue members have access to a growing number of Blue Distinction Centers® — more than 800 Blue Distinction designations have been awarded to over 650 facilities nationwide:
Bariatric Surgery: Developed with input from the American Society for Metabolic and Bariatric Surgery and the Surgical Review Corporation, there are more than 230 designated facilities.
Cardiac Care: Developed with input from the American College of Cardiology and The Society of Thoracic Surgeons, the program includes a broad range of cardiac services. There are more than 410 designated facilities.
Complex and Rare Cancers: Developed in strategic collaboration with the National Comprehensive Cancer Network, there are approximately 90 designated facilities focusing on 13 complex and rare subtypes of cancer.
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, Blue Distinction Centers (BDCs) include eight types of transplants. There are more than 80 designated facilities across the country.
* These organizations have provided information and input, but do not formally endorse the Blue Distinction Centers® program.
Various ongoing analyses of the Blue Distinction designations illustrate that BDCs are making a difference in patient quality and the cost of services. Specifically:
Among BDCs with the cardiac care designation
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
Source: HealthCore, Inc. Cardiac Multi-Plan Claims Analysis, 2008
Among BDCs with the transplant designation
The one-year mortality rate for adult heart transplants in BDCs is 11%, compared to 19% in non BDCs — a significant difference
Source: BCBSA RFI response data 2005, 2006, and 2007; data from the Scientific Registry of Transplant Recipients
Among BDCs with the bariatric surgery designation
The short-term major complication rate among BDCs is 5%, compared to 8% in non-BDCs
Source: BCBSA Analysis of hospital RFI data 2005, 2006, and 2007; BCBSA and HealthCore Cardiac Multi-Plan Claims Analysis, 2008.
