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High-Performance Network/Centers of Excellence

There is a major shift in health care today that is focused on improved health care delivery and better quality of care. Employers and health plans are behind this shift, using innovative strategies to deliver better outcomes and reduce costs. Two of these innovations include high-performance networks and centers of excellence (COEs).

Term Definition
High-performance network A small or select number of physicians, hospitals or other health care professionals who have been identified as high quality, cost effective providers.
Centers of excellence Providers who are selected to perform certain specialized procedures because of their expertise, outcomes and favorable financial arrangements.

More employers plan to provide these strategies in the future:

  • 11% of employers offer high-performance/narrow networks; expected to quintuple to 61% in 2018.
  • 37% of employers contract with a health plan for services at a COE; expected to surge to 62% in 2018.
  • 5% of employers contract directly with providers for services at a COE; expected to jump to 12% in 2018.

Traditionally, employers work with COEs for transplants, knee/hip and bariatric surgery. Employers have started working with COEs for a new range of procedures and conditions such as cancer, cardiac procedures, infertility treatments and transgender surgery.

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Featured Resources

Large Employers' 2019 Health Care Strategy and Plan Design SurveyLarge Employers' 2019 Health Care Strategy and Plan Design Survey
This year, the survey was redesigned to provide insight into large employers' views on the rapidly changing health care environment. This new information accompanies tried- and- true elements of the survey: critical benchmarking information on health care costs, plan design trends and employer initiatives.

Right Care, Right Place, Right Health Professional: Site of Care Benefit Manager Guide
Right Care, Right Place, Right Health Professional: Site of Care Benefit Manager Guide
Reviews the reasons employers are paying attention to where their employees seek care and provides recommendations to encourage employees to obtain care from high-value settings.

Leveraging COEs to Drive Change and Improve Outcomes
Leveraging COEs to Drive Change and Improve Outcomes
Key data on whether employers are offering centers of excellence to their employees, and, if so, for which conditions they are offered.

 

 

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ACO Toolkit: A Roadmap for Employers
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Selecting Evidence-Based Vendor Partners in the CDHP Era
Presents several items employers should keep in mind when selecting vendors to ensure their services are evidence-based.

Payment and Delivery Reform: Employers and Health Plans Committee
The Committee works on identifying and developing effective solutions to the major issues affecting benefits managers of large employers, promoting the collaboration of employers and their carriers and providing a forum where members may bring up concerns directly with their health insurance carriers.

Accountable Care Organizations Resources
Access all Business Group resources on Accountable Care Organizations.

 

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