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Blue Distinction®: New value-based designation

March 1, 2012

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Blue Distinction is a national designation program, developed in collaboration with the medical community to recognize those facilities that demonstrate expertise in delivering quality specialty care — safely, efficiently, and cost effectively. Blue Distinction Centers are a key part of Blue Plans? efforts to collaborate with physicians and facilities to improve the overall quality, and resulting affordability, of specialty care.

The Blue Distinction Centers for Specialty Care? program is evolving from a quality-focused designation to a more robust, value-based designation that will recognize those facilities that demonstrate expertise in delivering quality specialty care — safely, but also efficiently, and cost effectively.

The value-based designation is awarded to facilities that meet stringent quality measures, focused on patient safety and outcomes, as well as cost-of-care criteria, which will further differentiate Blue Distinction Centers from other facilities. This may result in a fewer number of facilities who are able to maintain their designation.

The Blue Cross and Blue Shield Association, an association of independent Blue Cross and Blue Shield plans, is scoring the Requests For Information (RFI) that facilities recently submitted for the Blue Distinction Spine Surgery and Knee and Hip Replacement programs applying the value-based criteria. The other designations currently offered include Cardiac Care, Bariatric Surgery, Complex and Rare Cancers, and Transplants. Eligible facilities may apply during the RFI cycle, when offered, for a particular designation. For the next RFI cycle for these designations, the value-based criteria will be applied.

For those facilities that meet the quality metrics, new cost criteria have been added to address market demand for affordable health care amid significant cost variation for the specialty care areas addressed by Blue Distinction programs.

On a national level, Blue Plans are active in marketing Blue Distinction Centers to nearly 100 million members through national public relations, recognition in a National Provider Directory, and other promotional efforts.

For more information regarding the Blue Distinction Program, please contact Phil Gehman at phil.gehman@ibx.com or 215-640-7694.

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