Blue Distinction is a program sponsored by Blue Cross and Blue Shield companies.  It aims to help consumers make more informed healthcare decisions. Blue Distinction involves collaboration with physicians and other providers to improve healthcare and affordability. Blue Cross and Blue Shield of Texas (BCBSTX) participates in Blue Distinction.

As part of Blue Distinction, BCBSTX launched BlueCompare, an enhancement to the online Provider Finder^®. BlueCompare is designed to help our members participate actively in the management of their own healthcare.

BlueCompare for Hospitals will provide two pieces of information to Provider Finder for medical/surgical general acute care hospitals that participate in the BlueChoice^® and BlueChoice Solutions networks. This program will start in the 4^th Quarter of 2007.

• The BlueCompare Affordability Scale compares acute care hospitals on medical/surgical costs for inpatient services. We adjusted the average cost of an inpatient stay so that hospitals performing more complex procedures on sicker patients can be reasonably compared to hospitals performing less complex procedures on less sick patients. The costs analyzed include all services provided by the hospital during an inpatient stay, such as lab, X-ray, medication, and room and board charges.

The analysis includes claims and membership for BCBSTX patients. A hospital’s BlueCompare Affordability Scale may not reflect its performance for all hospital patients.

There are five Affordability Scales that are represented in BlueCompare ranging from “more affordable” to “less affordable”.

The Affordability Scale is based on information in our Hospital Comparison Tool.  This online tool allows members to compare hospital outcome data for specific diagnoses and procedures, and on cost. The Hospital Comparison Tool can be accessed via http://www.bcbstx.com/provider/index.htm, Provider Tools/Programs, Hospital Comparison Tools, Consumer.

• The BlueQ Ribbon is based on our BlueQ Hospital Scorecard that reports hospital performance on The Joint Commission surveys, Leapfrog, and measures of patient safety and process of care from Centers for Medicare and Medicaid Services (CMS), Agency for Healthcare Research and Quality (AHRQ) and WebMD. We also give consideration to Blue Distinction Centers^SM that are recognized for excellence in cardiac care, transplants and bariatric surgery.

All medical/surgical general acute care hospitals are scored and ranked compared to hospital peers in eight geographic regions across the state of Texas.

a. Hospitals recognized for excellent performance are identified with a dark blue BlueQ Ribbon.

b. Hospitals recognized for commendable performance are identified with a light blue BlueQ Ribbon.

BlueQ reports were distributed to all medical/surgical general acute care hospitals in July, 2007, for whom adequate data was available.

BlueQ Ribbon Opt Out

A medical/surgical general acute care hospital can ”opt out” and choose to not display the BlueQ Ribbon in Provider Finder. Opting out is available for the BlueQ Ribbon only.  It does not apply to the Affordability Scale.  ”Opt out” will be effective for calendar years 2007 and 2008.  In 2007, however, Provider Finder will not display a Ribbon or an opt out explanation.  In early 2008, this information will be reflected in Provider Finder.

Note: The BlueCompare tool is provided for informational purposes only. BlueCompare information is available to help members and non-members select a health care provider. It is not intended as a recommendation to consumers.  Selection of a hospital provider is a personal choice.  Consumers should not make decisions solely on Affordability or BlueQ Ribbon designations displayed in BlueCompare. BlueCompare is based on BCBSTX claims and/or publicly reported information and may not be indicative of the hospital’s overall performance.

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