Blue Access for Producers

Blue Distinction Centers for Complex and Rare Cancers®

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.

Blue Distinction Centers for Complex and Rare Cancers were launched in March 2008. They offer a broad range of inpatient cancer care programs for adults, delivered by multidisciplinary teams with subspecialty training and distinguished clinical expertise in treating complex and rare subtypes of cancer. This initial program focuses on multidisciplinary treatment planning, complex inpatient care, and major surgical treatments for the following cancers:

  • Bladder cancer
  • Bone cancer — primary
  • Brain cancer — primary
  • Esophageal cancer
  • Gastric cancer
  • Head and neck cancers
  • Liver cancer — primary
  • Ocular melanoma
  • Pancreatic cancer
  • Rectal cancer
  • Soft tissue sarcomas
  • Thyroid cancer — medullary or anaplastic
  • Acute leukemia (inpatient/non-surgical)

These complex and rare cancers comprise approximately 15 percent of new cancer cases each year. Complex cancers involve complicated surgical procedures, requiring very specific skills and/or facilities and benefit from an integrated team approach. With the exception of acute leukemia, patients presenting with these diseases typically require complex surgical procedures performed by highly experienced surgical teams, with support by other specialists, to achieve optimal outcomes.

We recognize that the majority of patients' multidisciplinary treatment may be accomplished best by integrating the expertise available in a Blue Distinction Center® with locally available treatment resources, especially for outpatient chemotherapy and radiotherapy. We also recognize that optimal support of a patient's long term and palliative care needs may be served best by coordination of care between the patient, the patient's family, local physicians, the Blue Distinction Center and Blue Cross and Blue Shield of Texas (BCBSTX).

While facilities designated as Blue Distinction Centers for Complex and Rare Cancers may also treat a variety of cancers beyond those included in this program, this designation does not apply currently to other more commonly occurring types of cancers, such as breast, colon, prostate and lung cancers. Development of community-based Blue Distinction Center programs for these more common cancers is a future priority.

In determining the selection criteria for Blue Distinction, we collaborated with physician experts and medical organizations such as the National Comprehensive Cancer Network® (NCCN).* Potential Blue Distinction Centers submit clinical data to establish they meet the selection criteria, which include:

  • An established cancer program, actively providing cancer services and performing a required minimum surgical volume for at least five of the designated complex and rare cancer types
  • Appropriate experience of its complex and rare cancer team
  • An established acute care inpatient facility, including intensive care, emergency services and outpatient care
  • Full facility accreditation by a Centers for Medicare and Medicaid Services (CMS)-deemed national accreditation organization.
  • A comprehensive quality management program

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 its Blue Distinction Center designation, each facility must reapply periodically for re-designation. This not only encourages continuing quality at the facility level, but it also provides us with an opportunity to work with physicians and medical organizations to determine if any of the Blue Distinction quality thresholds should be raised to reflect current clinical practice. This process fosters ongoing opportunities for improving the overall quality of care.

Blue Distinction Centers for Complex and Rare Cancers, along with the Blue Distinction Centers for Bariatric Surgery®, Blue Distinction Centers for Cardiac Care®, Blue Distinction Centers for Knee and Hip ReplacementSM, 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.

* These organizations have provided information and input but do not formally endorse the Blue Distinction Centers program.

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 the customer service phone number on the back of your BCBSTX member ID card.