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Home / News & IndustryManaged Care Insight and Analysis
Updated: April 28, 2009
BCBSA Spearheads Initiative To Improve Healthcare Quality

The Blue Cross and Blue Shield Association (BCBSA) said that its Blue Distinction designation is demonstrating meaningful differences in healthcare outcomes and value, through collaboration with employer groups, providers and medical organizations to provide consumers with important quality information.

Blue Distinction is a nationwide program that recognizes medical facilities that meet objective, evidence-based thresholds for clinical quality developed in collaboration with expert physicians and medical organizations. This designation provides consumers with a credible, easily identifiable means of selecting facilities that best meet their individual specialty care needs.

To date, more than 800 Blue Distinction designations for specialty care have been awarded in 45 states and the District of Columbia in the areas of bariatric surgery, cardiac care, complex and rare cancers and transplants.

"The ever-expanding number of Blue Distinction Centers is a testament to the work Blue Cross and Blue Shield companies are doing nationwide to enhance healthcare quality, value and access," said Scott P. Serota, BCBSA president and CEO. "This is a true collaboration among key healthcare stakeholders, and together we are demonstrating that achieving improved clinical outcomes is a reality, not just rhetoric."

Blue Distinction Centers for Cardiac Care were awarded the designation because they met rigorous selection criteria that aim to significantly raise healthcare quality in America. 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 Care were lower than those performed at other hospitals for Blue Cross and 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 readmission rates for outpatient angioplasty based on 30-day cardiac-related readmission rates
  • 21 percent lower readmission rates for bypass surgery and 32 percent lower readmission rates for outpatient angioplasty based on 90-day cardiac-related readmission rates
  • lower costs, 5 percent less for bypass procedures or 12 percent less for outpatient angioplasty. with a 90-day episode of care

The HealthCore data is based on a claims analysis of 24 Blue Cross and Blue Shield companies to measure outcome and cost for patients treated at Blue Distinction-designated facilities compared to other facilities where cardiac care is provided. The analysis includes 41,333 patients treated within a facility setting, 22,322 of which were treated at Blue Distinction-designated facilities and 19,011 at other facilities. The analysis is based on cardiac events and procedures occurring during calendar year 2006, with follow-up in 2007.

Other analyses show that Blue Distinction Centers for Transplants are also demonstrating highly successful patient outcomes. The 1-year mortality rate for adult heart transplants is 11 percent in Blue Distinction Centers, compared to 19 percent at other facilities, according to an analysis of BCBSA RFI data, and data from the Scientific Registry of Transplant Recipients.

Address: Blue Cross Blue Shield Association, 225 North Michigan Ave., Chicago, IL 60601; (312) 297-6000, www.bcbs.com.


  This article was taken from:
The Executive Report on Managed Care

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