BlueCompare for Hospitals
BlueCompare for Hospitals provides two pieces of information in Provider Finder® for medical/surgical general acute care hospitals that participate in the BlueChoice® network.
The Affordability Scale is based on a comparison of participating general acute care hospitals’ costs for inpatient and outpatient services. The allowed amount per inpatient admission and outpatient services as determined by Blue Cross and Blue Shield of Texas (BCBSTX) is based upon taking a year's worth of commercial PPO claims for that provider and repricing it against their most current contract. This is then compared to the National Unadjusted Medicare Rate to obtain a percent of Medicare reimbursement rate. The costs BCBSTX uses for analysis include all services provided by the hospital during an inpatient stay, such as labs, X-rays, and medications, as well as the room and board charges and all services provided in the outpatient setting. The analysis includes claims and membership for BCBSTX patients. A hospital’s Affordability Scale may not reflect its performance for all hospital patients.
All medical/surgical general acute care hospitals are scored and ranked compared to hospital peers in eight geographic regions across the state of Texas. There are five Affordability Scales that are represented in BlueCompare ranging from "more affordable" to "less affordable".
The BlueQ Ribbon is based on our BlueQ Hospital Scorecard that reports hospital performance on The Joint Commission®, DNV Healthcare® or Healthcare Facilities Accreditation Program® surveys, Centers for Improvement in Healthcare Quality, Leapfrog, measures of patient safety and process of care from The Centers for Medicare and Medicaid Services (CMS).
We also recognize a hospital’s participation in voluntary initiatives for American Nurses Credentialing Centers’ (ANCC) Magnet Recognition Program or Pathway to ExcellenceTM designation. Additional scoring is done on the percent of out of network dollars, billed for certain categories for hospital-based providers. Bonus point consideration is given to Blue Distinction® Centers (BDC and BDC+) that are recognized for excellence in bariatric surgery, cardiac care, knee and hip replacement, maternity, transplants and spine surgery and to any additional disease certifications achieved through The Joint Commission©.
Inpatient surgical complication rate and inpatient readmission rates are also available as informational measures. All medical/surgical general acute care hospitals are scored and ranked compared to hospital peers in eight geographic regions across the state of Texas.
Hospitals recognized for exceeding expected performance are identified with a dark blue BlueQ Ribbon. Hospitals recognized for meeting expected performance are identified with a light blue BlueQ Ribbon.
BlueQ reports and BlueCompare results are distributed to all medical/surgical general acute care hospitals around November each year.
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. An "Opt out" will be effective for the following calendar year.
Note: The BlueCompare tool is provided for informational purposes only. BlueCompare information is available to help consumers make more informed health care decisions. Selection of a hospital is a personal choice. Consumers should not make decisions solely on Affordability Scale 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.