Blue Distinction Centers FAQs

What is Blue Distinction?

Blue Distinction is a designation awarded by Blue Cross and Blue Shield of North Carolina (Blue Cross NC) 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.

Where can I go for a full listing of facilities participating in the Blue Distinction Center programs?

You can find participating Blue Distinction Center facilities by following these instructions:

Click Find a Doctor
Select "Find a Doctor or Facility"
Select "Get medical care"
Select "Hospitals and Other Facilities"
Select a facility type
Use the Blue Distinction filter on the right side of the page

Where can I find the selection criteria for each Blue Distinction program?

Facilities are required to meet strict standards set by the medical community to earn the Blue Distinction name. Blue Cross and Blue Shield (BCBS) companies are committed to making this information easy to find and understand. Visit the Blue Cross and Blue Shield Association to learn more.

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 are designated Blue Distinction Centers 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 includes 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, are these services 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 Blue Cross NC network. To find out which services and costs are covered under your policy for any facility, please call the Customer Service number on your Member ID card.

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 (Blue Cross NC) network?

That facility would no longer be part of the Blue Cross NC 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 Bariatric Surgery?

Blue Distinction Centers for Bariatric Surgery are designated facilities within the participating Blue Cross and Blue Shield of North Carolina network that offer comprehensive bariatric surgery services for the purpose of weight loss.

What selection criteria do hospitals need to meet to be designated as a Blue Distinction Center for Bariatric Surgery?

Blue Distinction Centers for Bariatric Surgery were developed in collaboration with the American Society for Metabolic and Bariatric Surgery, Surgical Review Corporation and American College of Surgeons¹ and with input from a national panel of expert physicians.

What are Blue Distinction Centers for Complex and Rare Cancers?

Facilities are required to meet strict standards set by the medical community to earn the Blue Distinction name. Blue Cross and Blue Shield (BCBS) companies are committed to making this information easy to find and understand. Visit Blue Cross and Blue Shield Association to learn more.

Blue Distinction Centers for Complex and Rare Cancers focus on multidisciplinary treatment planning and complex, major surgical treatments for the following malignancies:

acute leukemia (inpatient/nonsurgical)
bladder cancer
bone cancer
brain cancer - primary
esophageal cancer
gastric cancer
head and neck cancers

liver cancer
ocular melanoma
pancreatic cancer
rectal cancer
soft tissue sarcomas
thyroid cancer - medullary or anaplastic

What selection criteria are used to evaluate potential Blue Distinction Center for Complex and Rare Cancers designees?

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.

Why focus on complex and rare cancers and not more common cancers (i.e., breast cancer)?

Rare cancers occur so infrequently that most general oncologists and surgeons see very few of these patients. Because the volume of these cases is so low, treatment and outcomes for these cancers can vary greatly by physician and by health care facility. It's important that health care consumers find facilities that have ample experience in treating their particular form of cancer. Looking ahead, Blue Cross and Blue Shield companies anticipate expanding the list of facilities designated as Blue Distinction Centers for Complex and Rare Cancers, as well as developing future designations for facilities that treat more common forms of cancer.

What are Blue Distinction Centers for Spine Surgery?

What selection criteria are used to evaluate potential Blue Distinction Center for Spine Surgery designees?

What are Blue Distinction Centers for Transplants?

Blue Distinction Centers for Transplants 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 Transplant patients. These facilities demonstrate expertise in offering comprehensive inpatient Transplant services.

What selection criteria are used to evaluate potential Blue Distinction Center for Transplant designees?

What are Blue Distinction Centers for Cardiac Care?

Blue Distinction Centers for Cardiac Care designation are designated facilities within the Blue Cross and Blue Shield of North Carolina network that have demonstrated a commitment to quality care, resulting in better overall outcomes for cardiac care patients. These facilities demonstrate expertise in offering comprehensive cardiac services, including inpatient cardiac care and cardiac rehabilitation.

What selection criteria are used to evaluate potential Blue Distinction Center for Cardiac Care designees?

Blue Distinction Centers for Cardiac Care were developed in collaboration with the American College of Cardiology and Society of Thoracic Surgeons¹ and with input from a national panel of expert physicians.

What are Blue Distinction Centers for Knee and Hip Replacement?

Blue Distinction Centers for Knee and Hip Replacement 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 knee and hip replacement patients. These facilities demonstrate expertise in offering comprehensive inpatient knee and hip replacement services, including total hip and knee replacement.