The term Centers of Excellence (COE) is used broadly throughout the hospital and the pharmacy wholesalers’ industry. Generally, a COE offers specific programs within healthcare facilities that are combined with high concentrations of expertise and related resources centered on medical areas and it is delivered in a comprehensive, concise, and in laymen’s terms.
Today, the term is used in a variety of ways and has created unintended confusion of what it means to be a true COE. We believe only when health systems, pharmacy wholesalers, clinicians and payers work collaboratively can it be determined a provider or a facility is a true COE. The challenge that the industry faces, however, is how to unite the most highly rated medical centers, pharmacy wholesalers, surgeons, and physicians into one network. A new COE product is helping solve for that while demonstrably improving outcomes and reducing costs.
Key Elements of a True COE
Self-funded employers object to the enormous discrepancy in costs1 and outcomes for the same procedure.2 Variances in access to care, quality of care and all associated costs can create an unpredictable landscape.
By thoroughly vetting and partnering closely with all players, health systems can enhance and define standards of what it means to be a true COE: consistently delivering excellent outcomes, outstanding safety ratings and a patient-first approach. These qualities can also provide employers with the value-added benefit of bundled payments to control overall healthcare costs.
We believe this can only be achieved by a COE specialty administrator with expertise in the management of destination surgery programs. In this model, cross-functional teams work closely.
Business throughout the entire care continuum to help drive optimal patient safety and an overall quality experience.
One example of an organization working toward that true definition of a COE is Contigo Health. Contigo Health is bringing together clinicians, health systems, pharmacy wholesalers, and employers, all with the mission to support high-quality care, enhance associate engagement, control costs, and keep associates healthy.
Selecting an Employer Centers of Excellence
It is essential that no one is left out of the conversation when it comes to finding solutions to today’s biggest healthcare challenges. Providers should look for a clinically driven network that partners with top clinicians to help provide the highest quality outcomes in a destination COE program that includes a bundled cost. As an example, the Contigo Health ECEN Passport™ product is a new type of COE program that delivers access to high-quality care by bringing together the highest-rated medical centers, surgeons, pharmacy wholesalers, and physicians, all in one network.
Health care systems, pharmacy wholesalers, and physicians undergo a thorough evaluation process. Selection is made through an invitation-only request for information and an extensive review of quality, outcomes and patient satisfaction data. Fewer than 5 percent of health systems initially identified for participation in Contigo Health ECEN Passport meet all the quality requirements for consideration.3
Proven Results from a True COE
Employers, health systems, clinicians and patients participating in a true COE are enjoying better outcomes and experience amid lower variance and costs.
Since the era of self-funded plans began, employers and benefits managers have been puzzled by the fact that employees facing very similar health conditions had a wide variance with regard to both costs and time away from work. As an example, a recent study showed the employer-paid costs for joint replacement could vary by as much as 70 percent.4
By accessing the Contigo Health ECEN Passport™ program, that variance can be reduced to zero by utilizing bundled costs. At the same time, employers can have higher confidence that their associates are receiving high-quality care from one of the nation’s top clinical teams.
The high-touch approach taken by Contigo Health ECEN Passport™ providers and program administrator also leads to a higher degree of compliance on the part of patients. In a 2017 study, 9.1 percent of traditional joint patients receiving care with local, non-Contigo Health ECEN Passport™ providers required discharge to a skilled nursing facility after surgery, while Contigo Health ECEN Passport™ patients receiving surgery for similar conditions required no additional nursing facility coverage.6
Furthermore, participation in this style of network is shown to boost both patient experience and quality of care. Participation in Contigo Health ECEN Passport™ has also generated positive results for patient satisfaction and post-care outcomes. During the first quarter of 2020, Net Promoter Scores for joint, spine and bariatric patients was 87/100.5
As these examples show, aligned goals are best achieved through direct collaboration between health systems and employers/payers, and utilization of a patient-centric model. With these capabilities, organizations are demonstrably improving outcomes for their employees, saving costs and – most importantly – keeping the workforce healthy and ready for tomorrow.
Contigo Health is driven to keep raising the bar. Contigo Health, LLC creates new ways for clinicians, health systems and employers to work together. With the addition of Health Design Plus, a leading Health Plan Administrative Services (TPA) and COE administrator, Contigo Health delivers even more comprehensive services that can help optimize employee health benefits.
1 Kevin Kennedy, William Johnson, Sally Rodriguez, Niall Brennan. 2019. Past the Price Index: Exploring Actual Prices Paid for Specific Services by Metro Area. Health Care Cost Institute. https://healthcostinstitute.org/in-the-news/hmi2019-service-prices
2 Christine Castano, MD, Marin Love, Michael van Duren, MD, Lawrence Shapiro, MD, Robin Clarke, MD, Howard Beckman, MD. 2014. Working in Concert: A How-to-Guide to Reducing Unwarranted Variations in Care. California Healthcare Foundation. https://www.chcf.org/wp-content/uploads/2017/12/PDF-Working InConcertReducingVariations.pdf
3 Jonathan R. Slotkin, MD, Olivia A. Ross, M. Ruth Coleman, Jaewon Ryu. 2017. “Why GE, Boeing, Lowe’s, and Walmart Are Directly Buying Health Care for Employees. Harvard Business Review. https://hbr.org/2017/06/why-ge-boeinglowes-and-walmart-are-directly-buying-health-care-for-employees
4 Maria Castellucci, 2018. Joint replacement surgery costs vary greatly between hospitals. Modern Healthcare. https://www.modernhealthcare.com/ article/20180523/NEWS/180529981/joint-replacement-surgery-costs-varygreatly-between-hospitals
5 Contigo Health’s 2020 Member Satisfaction Dashboard, First quarter of 2020
6 Slotkin, Ross, Coleman, Ryu. 2017. Why GE, Boeing. Harvard Business Review. https://hbr.org/2017/06/why-ge-boeing-lowes-and-walmart-are-directlybuying-health-care-for-employees 10 Contigo Health’s 2020 Member Satisfaction Dashboard, First quarter of 2020