5 Things to Consider When Choosing a Centers of Excellence (COE) Program for Your Population

In today’s challenging market, employers need everything on their side when it comes to attracting and retaining top talent. Unbeatable benefits, for example? They’re practically non-negotiable for competitive organizations. And with healthcare costs on the rise, you’re probably open to advice about how to maximize what you can offer your team members.

The statistics speak for themselves. According to a 2023 health benefits survey from Mercer, the cost of health benefits rose 5.2% per employee in 2023. Smaller employers were hit even harder with a 7.8% increase. How can employers better contain these costs—without sacrificing health outcomes and damaging their culture of well-being?

Enter centers of excellence (COE) programs—a great choice for any employer who wants to save money and offer high-quality care. It might sound too good to be true, but it’s not.

So how does it work and how should an employer go about choosing the best COE benefit for their population? Read on.

The benefits of best-in-class centers of excellence programs

Value-based centers of excellence programs have a lot to offer companies and their employees—but not all COE benefits are created equal. Your employee population has a particular set of needs that can only be addressed by a best-in-class centers of excellence network. It’s important to make sure the program you choose is structured in a way that can…

• Better predict your organization’s healthcare spend. Say goodbye to the days of impossible-to-forecast costs. With the help of a value-based centers of excellence program, you’ll have a partner in negotiating set rates,  which will help you make more predictable healthcare cost estimates.
  
  
• Cut down on costs. Thanks to economies of scale, COE programs can score preferred prices—that’s what happens when you’re negotiating on behalf of millions! In addition, some COE programs offer warranties for care related to other covered procedures, meaning the COE—not the employer—is on the hook for any related complications or readmissions within a certain time frame. This approach has led to major savings for employers. Carrum Health customers, for example, have seen up to 45% savings per episode of care.
  
  
• Deliver the highest quality of care to patients. The best centers of excellence programs go above and beyond to ensure their members receive unparalleled service and top-notch care of the highest standard.

How to choose a centers of excellence benefit program for your population

Now that we’ve covered some of the benefits of value-based COE programs, let’s talk about how to find a best-in-class option that will give you and your employees the cost savings and high-quality care you deserve.

1. Look for quality and outcomes

A program can deliver the most amazing sales pitch in the world, but ultimately, only one thing really matters: results. Seek out key metrics that offer tangible proof that clients are truly experiencing cost savings and improved health outcomes among their population. Consider readmission rates, available warranties (plus who in the relationship holds the warranty), the rate at which the COE program avoids unnecessary procedures, and the program’s approach to building a provider network.

2. Review the payment model

A bundled payment model is superior to other options because it protects you and your employees from unpredictable costs and surprise bills. This approach is built on economies of scale, which means the heavy lifting of negotiation has already been done on behalf of millions. As a result, flat rates for pricey procedures and conditions have already been settled—and they’re more affordable than they would be in the traditional fee-for-service world.

Double-check the fine print to avoid being hit with any sneaky exceptions to what should be a straightforward bundled payment model. For you and your employees, it’s all about transparency.

3. Ask around

There’s no need to make this choice in a vacuum. Healthcare consultants and brokers exist to curate reviews and feedback about COE programs so decision-makers like you can feel more confident. Don’t be afraid to cross-check any of their claims or promises with the help of third-party peer-reviewed reports and case studies from their current customers. You could even consider reaching out to some of those customers to ask more about their experience.

4. Prioritize member experience

Your employees want the best care at the best price, but they also want to be able to access it without jumping through unnecessary hoops. The most user-friendly programs out there offer sophisticated mobile apps or other digital portals to make customer support and benefit information easily accessible for patients. When a platform like this isn’t available, it wastes time and adds extra stress for your team.

In addition, a value-based COE network knows how to make people feel seen and cared for amid the stress and worry of any complex medical situation. Think administrative support (e.g., gathering paperwork, setting up appointments), travel coordination, advice on managing social challenges, mental health support, and a single point person to serve as an empathetic, listening ear every step of the way.

5. Run the numbers

Grab a calculator or a math-minded member of your team and crunch those costs. We know this probably goes without saying, but a value-based COE program is only right for your organization if it actually offers a return on the investment you’re making. Play the comparison game and make sure any program you’re considering will give you the maximum benefit.

Make sure to double-check that especially expensive conditions (think cancer and cardiovascular procedures, for example) are covered. This will save you a lot of money in the long run.

In addition—but perhaps most importantly—take a good look at the utilization strategy. You won’t see much of an ROI if you are not able to get many (or any) eligible members to actually use the program. A best-in-class COE program will use intelligent data and technology to target and engage members who may need treatment; the program will also offer successful methods of ensuring the benefit is used, such as a way to require that members utilize the benefit for certain (or all) applicable procedures.

Aligning your company with the best value-based centers of excellence network can make a huge difference to your healthcare costs, not to mention the quality of care offered to your employees when they need it most. Take the time to understand all available COE programs before you choose where to make the investment. Your bottom line—and your team—will thank you.

The information contained on this page is for informational purposes only. No material is intended to be a substitute for professional medical advice, diagnosis, or treatment.