Blue Distinction is a quality designation that helps you find medical facilities that have demonstrated expertise in select procedures. It recognizes facilities that meet objective, evidence-based criteria for clinical quality. Blue Distinction was developed by the Blue Cross and Blue Shield Association in collaboration with expert physicians and medical organizations.
At the core of Blue Distinction are Blue Distinction CentersSM. There is often a great variation in how specialty patients are treated and evaluated. These centers provide Service Benefit Plan members with a means of identifying hospitals that meet their individual health care needs for select procedures and conditions. Blue Distinction's goal is to give you support and information for making more effective health care decisions when you need specialty care. The selection criteria helps to identify facilities that are appropriately staffed and are fully supportive of increasing patient health and safety.
Blue Distinction Centers have been established in four areas of specialty care:
- Bariatric Surgery
- Cardiac Care
- Complex and Rare Cancers
- Transplants
Bariatric Surgery
Bariatric surgery is also known as weight loss surgery or gastric bypass surgery. Blue Distinction Centers for Bariatric SurgerySM provide a full range of bariatric surgery care services, including inpatient care, post-operative care, outpatient follow-up care and patient education. There are more than 200 Blue Distinction Centers for Bariatric Surgery across the US.
Cardiac Care
The American Heart Association estimates that during this year 1.2 million Americans will experience a first or recurrent heart attack. When you or someone you care about needs heart related medical care, you want a facility that you can trust. Blue Distinction Centers for Cardiac CareSM have demonstrated their commitment to quality care that results in better overall outcomes for cardiac patients.
Blue Distinction Centers for Cardiac Care provide inpatient care, cardiac rehabilitation, cardiac catherization and cardiac surgery, including coronary artery bypass surgery. Currently, there are more tan 420 Blue Distinction Centers for Cardiac Care in the US.
Complex and Rare Cancers
Approximately 15 percent of new cancers each year involve complex or rare cancers.
Blue Distinction Centers for Complex and Rare CancersSM focus on cancer treatment. The initial phase of evaluation is based on patient assessment, treatment planning, complex inpatient care, and major surgical treatments for adults delivered by teams with distinguished expertise and subspecialty training for complex and rare cancers. The program focuses on thirteen types of cancers including, but not limited to, bladder, esophageal, gastric, liver, pancreatic, and thyroid cancer. More than 85 Blue Distinction Centers for Complex and Rare Cancer are available in the US.
Transplants
Blue Distinction Centers for TransplantsSM help you find the transplant program that best meets your needs. These centers provider a wide range of care for nine transplant types including, but not limited to, heart, lung, liver and pancreas transplants. To date, more than 80 Blue Distinction Centers for Transplants have been designated representing more than 250 transplants programs across the US.
Your Service Benefit Plan Coverage
If you are considering or in need of this type of care and would like to see a list of providers in your area, you can go to the online Provider Directory on this web site and click on Blue Distinction Centers in the left hand menu. This will access a directory of Blue Distinction Centers nationwide.
Please check the 2009 Service Benefit Plan brochure for more information about Blue Distinction Centers and benefits for transplants, cardiac care, bariatric care and care for complex and rare cancers. Benefits are only available for covered services, medical care and surgical care as indicated in the 2009 brochure. In addition, if you or a covered family member need care and want to use a Blue Distinction Center, please contact your local Blue Cross and Blue Shield Plan at the customer service number indicated on the back of your ID card for assistance.
As an example of how Blue Distinction Centers can help you with your medical decisions and care, Blue Distinction Centers for Transplants negotiate a payment for all the covered services performed during the "transplant period" or a defined number of consecutive days associated with a covered transplant procedure. If you use a Blue Distinction Center for Transplants for a covered transplant procedure, you pay only the $200 per admission deductible under Standard Option or the $100 per day copayment, up to $500, under Basic Option for the transplant period. You are not responsible for any additional costs for the professional services provided during this period. For care related to the transplant before and after the transplant period, benefits are provided at the regular Preferred benefit level, subject to deductibles, coinsurance and copayment amounts.