Wellmark Blue Cross and Blue Shield has recognized eight Iowa health care facilities as part of the Blue Distinction Centers for Specialty Care program in the area of bariatric surgery. These facilities have been designated as either Blue Distinction Centers, for delivering care resulting in better overall outcomes for bariatric patients, or as Blue Distinction Centers+, for delivering the same quality care as Blue Distinction Centers while also meeting key requirements for cost efficiency. Bariatric surgeries are among the most common elective surgeries in the United States; in 2018 there were 252,000 bariatric surgeries performed. In Greater Des Moines, Iowa Methodist Medical Center and MercyOne West Des Moines Medical Center were each designated Blue Distinction Centers+ in this specialty.