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Blue Cross and Blue Shield Association Expands Blue Distinction(R) Designation to Include Spine Surgery, Knee and Hip Replacement

More than 800 facilities to receive the new designations as part of The Blues(R) nationwide initiative to improve healthcare quality and safety

CHICAGO, Jan. 27 /PRNewswire-USNewswire/ --The Blue Cross and Blue Shield Association (BCBSA) today announced the expansion of its Blue Distinction designation program to include Blue Distinction Centers for Spine Surgery(SM) and Blue Distinction Centers for Knee and Hip Replacement(SM).  Blue Distinction designations are awarded to facilities that have demonstrated a commitment to quality care by meeting objective, evidence-based thresholds for clinical quality and safety developed with input from expert clinicians and leading professional organizations.

"The number of patients undergoing surgeries and hospitalizations for spine, knee and hip conditions is growing dramatically," said Allan Korn, MD, senior vice president and chief medical officer, BCBSA.  "These new designations will help provide patients and their physicians with a credible means of selecting facilities that meet their individual healthcare needs, while encouraging healthcare professionals to improve the overall quality and safety of care."

Procedures including knee reconstruction or replacement, total and partial hip replacement, and spinal fusion, increased by nearly 25 percent between 1997 and 2005.(1) "Numerous studies have shown that hip and knee replacement programs that incorporate evidence-based clinical care pathways have better outcomes and fewer postoperative complications in their patients," said Kevin J. Bozic, MD, MBA*, associate professor and vice chair of orthopaedic surgery at University of California, San Francisco.  "The selection criteria that were used to designate Blue Distinction Centers emphasize important aspects of quality and safety of patient care.  These designations will help patients and referring physicians identify hospitals that offer comprehensive, integrated orthopaedic care."

The addition of the two new Blue Distinction designations will bring the nation's number of Blue Distinction designations to more than 1,600, across 46 states and the District of Columbia, and this number is expected to increase in the coming years.  By March 2010, more than 300 Spine Surgery and more than 500 Knee and Hip Replacement facilities are anticipated to be designated as Blue Distinction Centers.

"As the volume of patients receiving spine surgery grows in the United States, it becomes increasingly important to help these patients and their physicians identify facilities that have experience in comprehensive non-surgical spine care, surgical expertise, and post operative rehabilitation," said Daniel K. Resnick, MD, MS*, associate professor and vice chairman of neurological surgery at University of Wisconsin, Madison.  "Using a multidisciplinary approach and tracking patient outcomes allows for effective and individualized patient care.  The selection criteria used for the Blue Distinction program designation represent distinguished quality, and participating centers should be commended for their efforts at improving patient care."

The selection criteria used to evaluate facilities were developed with input from a panel of expert physicians and medical organizations.**  To be designated as a Blue Distinction Center for Knee and Hip Replacement or a Blue Distinction Center for Spine Surgery, the following types of criteria were evaluated.  More information on selection criteria is available on

  • Established acute care inpatient facility, including intensive care, emergency care, and a full range of patient support services with full accreditation by a CMS-deemed national accreditation organization
  • Experience and training of program surgeons, including case volume
  • Quality management programs, including surgical checklists as well as tracking and evaluation of clinical outcomes and process of care
  • Multi-disciplinary clinical pathways and teams to coordinate and streamline care, including transitions of care
  • Shared decision making and preoperative patient education

In addition to recognizing Blue Distinction Centers, Blue Cross and Blue Shield companies are proactively encouraging improvement by facilities that did not initially achieve the Blue Distinction designation.  Non-designated facilities are provided feedback reports indicating areas for quality improvement in an ongoing effort to help them become a Blue Distinction Center.  To support ongoing quality and safety, designated Blue Distinction facilities also are re-evaluated on a regular basis.

The Blue Distinction designation is awarded by the Blue Cross and Blue Shield companies to medical facilities that have demonstrated expertise in delivering quality healthcare in the areas of bariatric surgery, cardiac care, complex and rare cancers, knee and hip replacement, spine surgery and transplants.  The program is part of The Blues efforts to collaborate with physicians and medical facilities to improve the overall quality and safety of specialty care.

For a complete listing of Blue Distinction Centers for Spine Surgery and Blue Distinction Centers for Knee and Hip Replacement, or for more information on all designated Blue Distinction Centers, please go to or call 1.800.810.BLUE.***

The Blue Cross and Blue Shield Association is a national federation of 39 independent, community-based and locally operated Blue Cross and Blue Shield companies that collectively provide healthcare coverage for more than 100 million members - one-in-three Americans.  For more information on the Blue Cross and Blue Shield Association and its member companies, please visit


(1) Agency for Healthcare Research and Quality (AHRQ) Statistical Brief #34, Hospital Stays Involving Musculoskeletal Procedures 1997-2005, July 2007

*  Each member of the Blue Distinction Expert Panel is engaged as an independent consultant and offered a nominal honorarium.  Expert panelists do not serve as representatives of any professional organization, but as learned individuals who inform discussions on evaluating quality in patient care with knowledge based on their own clinical experience.  Expert opinions expressed are those of the individual expert and do not represent the opinions of any medical organization.

**  Medical organizations, including the North American Spine Society and the American Association of Neurological Surgeons, are generally supportive of quality based initiatives and have observed expert panel deliberations and provided input and information, but they do not formally endorse the Blue Distinction Centers Program or any other program.

***  Some Blue companies may already participate in local Spine Surgery and Knee and Hip Replacement programs.  The Blue Distinction Centers for Spine Surgery and Blue Distinction Centers for Knee and Hip Replacement do not disrupt or replace these existing programs.

Note:  Designation as Blue Distinction Centers means these facilities' overall experience and aggregate data met objective criteria established in collaboration with expert clinicians' and leading professional organizations' recommendations.  Individual outcomes may vary.  To find out which services are covered under your policy at any facilities, please call your local Blue Cross and/or Blue Shield Plan.

SOURCE Blue Cross and Blue Shield Association



SOURCE Blue Cross and Blue Shield Association
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