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Blue Distinction Specialty Care: An Overview

The choices you make matter – especially when it comes to your healthcare.

The healthcare facility you select can have a direct impact on the care you receive and your procedure results. But finding the right facility can sometimes be a challenge.

Blue Cross Blue Shield companies understand you deserve peace of mind when making these important healthcare decisions with your doctor. That’s why we developed the Blue Distinction Centers recognition program to identify facilities with proven expertise in delivering specialty care.

We turned to the medical community for input on how to measure facility performance. Our evaluation criteria are based on what impacts you and your care the most, including:

  • The expertise of the medical team;
  • The number of times the facility has performed the procedure; and,
  • The facility’s track-record for procedure results.

The result: Two different recognitions for healthcare facilities that can help inform your search for the right specialty care:

Quality remains key: only those facilities that first meet nationally established, objective quality measures for Blue Distinction Centers will be considered for designation as a Blue Distinction Center+.

Both Blue Distinction Centers and Blue Distinction Centers+ have a proven track-record for delivering better results – including fewer complications and readmissions – than facilities without these recognitions.

Bariatric Surgery

Morbid obesity is widely recognized as a contributor to serious health risks; yet, according to the Centers for Disease Control and Prevention, approximately 72 million Americans are obese. A portion of the individuals facing this condition, more than 179,000 in 2013 according to the American Society for Metabolic and Bariatric Surgery, may opt for bariatric surgery as a tool to aid in long-term weight-loss and increase their quality of health. Why? Bariatric surgery has been shown to help improve or resolve many obesity-related conditions, such as type 2 diabetes, high blood pressure, heart disease, and more. Additionally, many individuals who improve their weight find themselves taking less and less medications to treat their obesity-related conditions.

Since its inception in 2008, Blue Distinction Specialty Care has aided Blue Cross Blue Shield members along with their physicians in identifying facilities with a history of quality care. In January 2015, the program expanded to include Blue Distinction Centers+ for Bariatric Surgery, focused on identifying facilities that offer cost-efficiency in addition to a history of quality care.

Blue Distinction Centers and Blue Distinction Centers+ for Bariatric Surgery designations are awarded for two types of bariatric procedures: gastric stapling (only hospitals are eligible to apply) and gastric banding (both hospitals and ambulatory surgery centers are eligible to apply). To be considered for designation, the facility must provide a full range of bariatric surgery care, including inpatient care, post-operative care, outpatient follow-up care and patient education.

Find a Center near you:

To view the list of designated healthcare facilities, you will need Adobe Acrobat Reader® to view the document. If you do not have Acrobat, please click here to download it for free.

Cardiac Care

According to the National Center for Chronic Disease Prevention and Health Promotion, cardiovascular disease is the leading cause of death in the United States, claiming nearly 600,000 lives each year. When it is you or someone you care about that is in need of heart care, you want to find a facility you can trust.

Research shows that Blue Distinction Centers and Blue Distinction Centers+ demonstrate better quality and improved outcomes for patients, with lower rates of complications following certain cardiac procedures and lower rates of healthcare associated infections compared with their peers. Blue Distinction Centers+ are also 20 percent more cost-efficient than non-designated hospitals for those same cardiac procedures.

Blue Distinction Centers and Blue Distinction Centers+ for Cardiac Care provide a full range of cardiac care services, including inpatient cardiac care, cardiac rehabilitation, cardiac catheterization and cardiac surgery (including coronary artery bypass graft surgery).

To date, we have designated healthcare facilities in the majority of states across the U.S.

Find a Center near you:

To view the list of designated healthcare facilities, you will need Adobe Acrobat Reader® to view the document. If you do not have Acrobat, please click here to download it for free.

Complex and Rare Cancers

Complex and rare cancers comprise approximately 15 percent of new cancer cases each year. The Blue Distinction Centers for Complex and Rare Cancers Program evaluates facilities on patient assessment, treatment planning, complex inpatient care and major surgical treatments for adults; all delivered by teams with distinguished expertise and subspecialty training for complex and rare cancers. The program focuses on the following 13 cancers:

  • Bladder cancer
  • Brain cancer – primary
  • Esophageal cancer
  • Gastric cancer
  • Liver cancer – primary
  • Pancreatic cancer
  • Rectal cancer
  • Acute leukemia (inpatient, non-surgical)
  • Bone cancer – primary
  • Head and neck cancers
  • Ocular melanoma
  • Soft tissue sarcoma
  • Thyroid cancer – medullary or anaplastic

To date, more than 90 of the nation's cancer facilities have been designated as Blue Distinction Centers for Complex and Rare Cancers.*

Find a Center near you:

Additional Resources

Blue Distinction Centers for Complex and Rare Cancers were developed in strategic collaboration with the National Comprehensive Cancer Network (NCCN).** View a complete listing of NCCN member institutions.

Click here for additional resources regarding complex and rare cancers.

The Blue Cross and Blue Shield System 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.

Some Blue Cross and Blue Shield companies may already participate in local cancer care programs. The Blue Distinction Centers for Complex and Rare Cancers program neither disrupts nor replaces the Blue Companies' own existing programs.

*Specific subtypes of complex and rare cancers for which a facility met our selection criteria are identified alongside its name but are not intended as a comprehensive list of all cancer care services that the facility may offer.

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

Knee and Hip Replacement

If your joints have suffered damage from arthritis or injury, you may find it difficult to complete everyday activities such as walking or climbing stairs. Whether you're exploring treatment options with your doctor or have already decided to have knee or hip replacement surgery, the Blue Distinction Center program can help you find the right hospital for the specific procedure you need.

Using objective information and input from the medical community, Blue Cross and Blue Shield companies have designated hospitals as Blue Distinction Centers that are proven to outperform their peers in the areas that matter to you – quality, safety and, in the case of Blue Distinction Centers+, efficiency.

Blue Distinction Centers and Blue Distinction Centers+ for Knee and Hip Replacement provide comprehensive inpatient knee and hip replacement services, including total knee replacement and total hip replacement surgeries.

To date, we have designated healthcare facilities in the majority of states across the U.S.

Find a Center near you:

Spine Surgery

Studies confirm that as many as eight out of 10 Americans suffer from some sort of back pain. Many ways to treat back pain are available, and your doctor can guide you toward the most appropriate recommendation for your situation. For those with severe and/or chronic back pain, spine surgery may be a treatment option.

If you or someone you love needs spine surgery, look to the Blue Distinction Center program to help you and your doctor make an informed decision about your care.

Research confirms that hospitals designated as Blue Distinction Centers and Blue Distinction Centers+ for Spine Surgery have fewer complications and fewer hospital readmissions than non-designated hospitals. Blue Distinction Centers+ for Spine Surgery also deliver care more efficiently than their peers.

Blue Distinction Centers and Blue Distinction Centers+ for Spine Surgery provide comprehensive inpatient spine surgery services, including discectomy, fusion and decompression procedures.

To date, we have designated healthcare facilities in the majority of states across the U.S.

Find a Center near you:

To view the list of designated healthcare facilities, you will need Adobe Acrobat Reader® to view the document. If you do not have Acrobat, please click here to download it for free.

Transplants

More than 120,000 people in the United States were registered for organ donations from one of the nation's more than 800 transplant programs.* The Blue Distinction Centers for Transplants program can help you find the transplant program that meets your needs.

Blue Distinction Centers and Blue Distinction Centers+ for Transplants have demonstrated their commitment to quality care, resulting in better overall outcomes for transplant patients. Each facility meets stringent clinical criteria, established in collaboration with expert physicians' and medical organizations' recommendations**, including the Center for International Blood and Marrow Transplant Research (CIBMTR), the Scientific Registry of Transplant Recipients (SRTR) and the Foundation for the Accreditation of Cellular Therapy (FACT), and is subject to periodic re-evaluation as criteria continue to evolve. Both Blue Distinction Centers and Blue Distinction Centers+ for Transplants help simplify the administrative process involved in this complex care so that patients, their families, and physicians can focus on the medical issues.

Hospitals receiving the Blue Distinction Center+ for Transplants designation have met the Blue Distinction Centers' standards for quality while also demonstrating better cost-efficiency relative to their peers.

Blue Distinction Centers for Transplants provide a range of services for the following transplant types:

  • Heart
  • Lung
  • Liver
  • Pancreas
  • Bone marrow/stem cell

 Find a Center near you:

To view the list of designated healthcare facilities, you will need Adobe Acrobat Reader® to view the document. If you do not have Acrobat, please click here to download it for free.

More Information

Additional resources about transplant services, including sources of potential financial assistance and a directory of available patient advocates and education are available.

*Source: The Organ Procurement and Transplantation Network (OPTN), the unified transplant network established by the United States Congress under the National Organ Transplant Act (NOTA) of 1984. Visit www.optn.org to learn more.

**These organizations have provided information and input, but do not formally endorse the Blue Distinction Centers program.

For Hospitals or Physicians

If you are a physician or hospital administrator interested in learning more or applying for the Blue Distinction Center or Blue Distinction Center+ designation for your medical facility, please click here.

Blue Distinction Centers (BDC) met overall quality measures for patient safety and outcomes, developed with input from the medical community. Blue Distinction Centers+ (BDC+) 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. For details on Local Blue Plan Criteria, a provider’s in-network status, or your own policy’s coverage, contact your Local Blue Plan. Each facility’s cost of care is evaluated using data from its Local Blue Plan. Facilities in CA, ID, NY, PA, and WA may lie in two Local Blue Plans’ areas, resulting in two evaluations for cost of care; and their own Local Blue Plans decide whether one or both cost of care evaluation(s) must meet BDC+ national criteria. Neither Blue Cross and Blue Shield Association nor any Blue Plans are responsible for damages 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.