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Why we have Blue Distinction centers
The growing obesity epidemic is a serious health concern. Requests for Bariatric Surgery are on the rise throughout the country. While many surgeons and hospitals are willing to perform this operation, their experience varies greatly.

The Blue Distinction Centers for Bariatric Surgery program has identified the hospitals that met a broad range of criteria, focusing on experience and surgical outcomes. Use of such centers has typically improved health outcomes and financial performance by lowering complications.

Types of Blue Distinction centers and who may use them
If you are a member of Blue Cross and Blue Shield of New Mexico, you may take advantage of the Blue Distinction Centers for Bariatric Surgery. If you are seeking care in Illinois, look below to find the centers available for you.

If you are seeking care in a state other than Illinois, you may take advantage of the Blue Distinction Centers for Bariatric Surgery. You can find these centers by going to the Blue Distinction Centers for Bariatric Surgery.

Members using the Blue Distinction Centers still have to meet medical necessity criteria for the surgery. See the section "Medical Policy on Surgery".

If you are not a member of Blue Cross and Blue Shield of New Mexico, the information on this Web site may not apply to you - Please contact your own health plan.

How the Blue Distinction centers were formed
Selection criteria for the Blue Distinction Centers for Bariatric Surgery were developed with the objectives of improving overall patient outcomes and delivering better value. The criteria used to designate the Centers were established through collaboration with expert physician panels and national organizations.

Criteria for Blue Distinction Centers for Bariatric Surgery evaluate:

  • Full-service, accredited inpatient hospital facility;
  • Program must be performing bariatric surgery for the most recent 18-24-month period and must perform a required volume of bariatric surgical cases;
  • Experience and credentialing of the bariatric surgical team;
  • Ongoing quality management and improvement programs;
  • Appropriate equipment and staffing; and
  • Patient care and follow-up care including evaluation of bariatric surgery complication and mortality rates.

Member participation
Member participation is voluntary. Although members whose benefit plan includes coverage for bariatric surgery will be advised of the Blue Distinction Centers, the members will remain free to choose other contracted facilities without penalty. The member must complete a medical weight management program and all other criteria in the medical policy on Surgery for Morbid Obesity must be satisfied before bariatric surgery can be considered. When using a Blue Distinction Center for Bariatric Surgery members should confirm that the surgeon is part of the contracting network by calling customer service. Members will not receive in network benefits for the services of surgeons or other providers who are not in the contracted provider network of the member's health plan.

The HMO program follows a different procedure than that described above. If you are an HMO member, consult with your Primary Care Physician regarding the most appropriate treatment for your condition.

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an Independent Licensee of the Blue Cross and Blue Shield Association.

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