Blue Distinction Centers for Knee and Hip ReplacementSM
Blue Distinction® recognizes facilities that meet objective, evidence-based thresholds for clinical quality, developed in collaboration with physicians and medical organizations. At the core of Blue Distinction are the Blue Distinction Centers for Specialty Care®, providing our members with a credible, easily identifiable means of selecting facilities that meet their individual health care needs.
The Blue Distinction Centers for Knee and Hip ReplacementSM demonstrated an objective commitment to quality care, resulting in better overall outcomes for patients who undergo knee and hip replacement procedures. These facilities have demonstrated experience in offering a broad range of inpatient knee and hip replacement services, including total knee replacement and total hip replacement. To date, more than 500* facilities nationwide have met our evidence-based selection criteria.
We received input from expert physicians and medical organizations to determine the selection criteria for all Blue Distinction programs. Candidates for Blue Distinction Centers for Knee and Hip Replacement must submit clinical data to establish that they meet the selection criteria, which include:
- An established acute care inpatient facility, including intensive care, emergency care and a full range of patient support services
- Full accreditation by a Centers for Medicare and Medicaid Services (CMS)-deemed national accreditation organization
- A comprehensive quality management program
- An established knee and hip replacement program, performing required annual volumes for certain procedures (for example, at least 100 total hip and total knee joint replacement surgeries [primary and revision] per year, with a minimum of 25 each total hip and total knee replacements)
- An experienced knee and hip replacement surgery team, including surgeons with board certification, subspecialty fellowship training, and case volumes that meet the selection criteria for knee and hip replacement procedures
- Pre-operative patient education
- Processes that support transitions of care
- Multi-disciplinary teams and clinical pathways to coordinate and streamline care
- Use of an internal registry or database to track patient outcomes over time
- Participation in the Surgical Care Improvement Project (SCIP) with = 90 percent performance on process measures
- Clinical outcomes that meet objective thresholds, such as complication rates and length of stay, for specific procedures
Detailed selection criteria are publicly available, providing consumers with support for their health care decisions and facilities with a clinically established path for quality improvement.
To maintain their designations as Blue Distinction Centers for Knee and Hip Replacement, all facilities will be required to reapply periodically for re-designation. This not only encourages continuing quality at the facility level, but also provides us with an opportunity to work with physicians and medical organizations to determine if any Blue Distinction quality thresholds should be raised to reflect current clinical practice. This process fosters ongoing opportunities for Blue Distinction to improve the overall quality of care.
Blue Distinction Centers for Knee and Hip Replacement, along with Blue Distinction Centers for Bariatric Surgery®, Blue Distinction Centers for Cardiac Care®, Blue Distinction Centers for Complex and Rare Cancers®, Blue Distinction Centers for Spine SurgerySM, and Blue Distinction Centers for Transplants® are a key part of our efforts to collaborate with physicians and facilities to improve the overall quality, and resulting affordability, of specialty care.
* Approximate number of designated facilities by the end of Q1 2010
Note: Designation as Blue Distinction Centers means these facilities' overall experience and aggregate data met objective criteria established with input from 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 the customer service phone number on the back of your Blue Cross and Blue Shield of New Mexico member ID card.