Blue Distinction® Centers for Knee and Hip Replacement Program

Blue Distinction Specialty Care is a national designation program, awarded by local Blue Cross and Blue Shield (BCBS) companies, recognizing healthcare providers that demonstrate expertise in delivering quality and affordable healthcare to meet consumers’ specialty care needs—safely, effectively, and cost-efficiently.

The 2025 Blue Distinction Centers for Knee and Hip Replacement Program will evaluate acute care hospitals and ambulatory surgery centers that offer elective total knee replacement and total hip replacement services for adult patients (ages 18 and over) with degenerative disease.

This designation is a mark of quality and can enhance the hospital's reputation among patients, healthcare professionals, and insurers.

What measures are being reported for participation?

The AAOS will provide BCBSA with aggregate, patient deidentified performance metric reporting at the site and surgeon level for participating sites that have executed the consent form, for American Joint Replacement Registry (AJRR) measures identified below:

  • 90-day unplanned all cause inpatient readmission (hospitals) / admissions (ASCs)
  • 90-day major complication composite
  • 90-day postoperative mortality rate
  • Preoperative and postoperative functional/health assessment status inpatient measures, for hospitals:
    • THKR-IP-4a – Preoperative Functional/Health Status Assessment – Hip and Knee Overall
    • THKR-IP-5a – 3-month Postoperative Functional/Health Status Assessment – Hip and Knee Overall
  • Preoperative and Postoperative Functional/Health Status Assessment Measures, for ASCs:
    • THKR-OP-4a – Preoperative Functional/Health Status Assessment – Hip and Knee Overall
    • THKR-OP-5a – 3-month Postoperative Functional/Health Status Assessment – Hip and Knee Overall

What steps do participating AJRR sites need to take to allow performance metrics to be submitted?

We welcome participating sites to to reach out to to sign a data-sharing agreement. No data will be shared with BCBSA until a data share consent agreement form is completed and added as an addendum to the respective registry participation contract.

In the meantime, participating registry sites can continue data submission for measure data elements. The data will be refreshed each quarter and submitted to BCBSA.

To calculate the required performance measures, participating sites need to submit procedure, post-discharge (90-day unplanned readmissions or return to OR), and patient-reported outcome measures (PROMs) data elements. The procedures submitted create the measure denominator populations, while the numerators are identified via complications coding submitted in the post-op file and completed functional and global health status assessments submitted via the PROMs file, the Registry PRO Portal, or via a third-party vendor.

For a complete list of inclusion and exclusion coding and data element criteria, please view this document. Reports will be submitted on a quarterly basis.

Do I have to be a participating AJRR site to submit data for consideration as a Blue Distinction Specialty Center?

For the 2025 Designation Evaluation, sites can submit quality measure data via AJRR or the BCBSA Provider Survey. For all future Designation Evaluations, participation and measure submission with AJRR will be required.

Is there a specific time period that AJRR participating sites need to provide consent?

The AAOS registries will send performance measure reports to BCBSA on a quarterly basis. In order to be included in the reports, interested AJRR participating sites must provide consent. Click here to view the data share consent agreement form.

When can participating sites begin submitting performance metrics to BCBSA?

As of June 2024, consenting AJRR sites can submit performance metrics via the BCBS survey tool or the AAOS Registry Program for 2025 Designation Evaluation. AAOS Registry participation will be the sole pathway for performance measure submission starting with all future review cycles.

To learn more about the AJRR or how to submit your completed data consent form, email or call 847-292-0530.