What is Blue Distinction®
Blue Distinction is a designation awarded by Blue Cross and Blue Shield of North Carolina (BCBSNC) and other Blue Cross and Blue Shield companies to medical facilities that have demonstrated expertise in delivering quality health care. The designation is based on rigorous, evidence-based selection criteria established in collaboration with expert physicians and medical organizations. The goals are to raise the quality of care delivered nationwide and to help consumers find specialty care at facilities proven to have delivered better overall outcomes.
How are Center of Excellence (COE) and Blue Distinction Center®
Blue Cross and Blue Shield of North Carolina's (BCBSNC's) Centers of Excellence and the Blues' nationally branded Blue Distinction Centers® both recognize medical facilities that have demonstrated expertise in delivering quality specialty care. BCBSNC's original quality programs were called Centers of Excellence. The Blues also developed nationally consistent quality designation programs, known as Blue Distinction Centers. BCBSNC converted to the national Blue Distinction Centers programs, thus ending its use of the Centers of Excellence name, except for BCBSNC's Bariatric Surgery Centers of Excellence.
BCBSNC's Bariatric Surgery Centers of Excellence program has focused on outstanding surgeons who perform bariatric surgery, rather than outstanding facilities. The BCBSNC Bariatric Surgery Centers of Excellence program will end on December 31, 2009. In its place will be Blue Distinction Centers for Bariatric Surgery, which focus on facility performance, using BDC's transparent, evidence-based selection criteria and existing program structure. While the Blue Distinction Center designation is given to the facility, the work, volumes, and outcomes of quality physician services still lie at the heart of the selection criteria for earning this quality designation.
Where can I go for a full listing of facilities participating in the Blue Distinction Center programs?
To view a full listing of facilities participating in the Blue Distinction Center for Spine Surgery, Knee and Hip Replacement, Bariatric Surgery, Cardiac Care and Complex and Rare Cancers, visit:
Where can I find the selection criteria for each Blue Distinction program?
Blue Cross and Blue Shield companies are committed to making health care information accessible and transparent. Selection criteria used to evaluate facilities applying for designation as a Blue Distinction Center are available on the Blue Cross Blue Shield Association website.
If a facility meets the selection criteria for designation for one of the Blue Distinction programs, does that mean it receives designation for all Blue Distinction programs?
No. These programs focus on identifying (and recognizing) what it takes for health care facilities to deliver better outcomes for specific types of specialty care.
Selection criteria are unique for each Blue Distinction program, reflecting that particular area of specialized care. Understandably, a facility with proven expertise in one specialty area may or may not meet thresholds in other areas (for example, a Blue Distinction Center for Spine Surgery may not necessarily meet the selection criteria for becoming a Blue Distinction Center for Complex and Rare Cancers). A facility that has been designated a Blue Distinction Center in multiple areas of care has met our detailed criteria in each area.
What does this say about facilities that are not listed as Blue Distinction Centers?
Some hospitals don't treat sufficient volumes for the specific specialty type, so they cannot be considered for the program. This program is also voluntary, so facilities that did not apply for consideration during the application cycle are not eligible to be designated as Blue Distinction Centers until they apply during a subsequent cycle.
How often will facilities designated as a Blue Distinction Center be evaluated?
All facilities must reapply for the designation on a regular basis (typically every 18 - 36 months) to help maintain consistent quality among facilities that have earned the Blue Distinction designation. The purpose of this process is to confirm that Blue Distinction designated facilities continue to meet the selection criteria. Requirements for ongoing participation as a Blue Distinction Center may evolve as the programs matures, but generally will include evaluation of quality indicators in the areas of structure, processes and outcomes.
If I choose to be treated at a facility that is not designated as a Blue Distinction Center, will these services be covered?
Services received at facilities without a Blue Distinction Center designation may be covered under the terms of your benefits. Out-of-pocket costs may be higher if you receive care at a facility outside of the BCBSNC network. To find out which services and costs are covered under your policy for any facility, please call BCBSNC Customer Service.
Does the Blue Distinction Center designation also apply to doctors at those facilities?
The Blue Distinction Center designation focuses solely on facilities' procedures and the outcomes, which are a result of the performance for all physicians who perform these procedures at the facility.
What happens if a Blue Distinction Center designee drops out of the Blue Cross and Blue Shield of North Carolina (BCBSNC) network?
That facility would no longer be part of the BCBSNC network or the Blue Cross Blue Shield Association network and would no longer be considered a Blue Distinction Center.
What are Blue Distinction Centers for Spine Surgery?
Blue Distinction Centers for Spine Surgery are designated facilities within the Blue Cross and Blue Shield of North Carolina network that demonstrate a commitment to quality care, resulting in better overall outcomes for spine surgery patients. These facilities demonstrate expertise in offering comprehensive inpatient spine surgery services, including discectomy, fusion and decompression procedures.
What selection criterion are used to evaluate potential Blue Distinction Center for Spine Surgery designees?
Blue Cross and Blue Shield companies are committed to making health care information accessible and transparent. Selection criteria used to evaluate facilities applying for designation as a Blue Distinction Center is available on the Blue Cross and Blue Shield Association website.