Centers of excellence are becoming the next big thing in health care coverage, as employers seek to control costs while improving employee health outcomes.
Modern Healthcare reported on the findings of a survey from Willis Towers Watson, which showed an increase in the number of employers giving employees access to COEs — organizations that have high quality ratings in specialties such as cardiac or orthopedic services and infertility. In 2015, just 37 percent of employers gave their employees access to COEs; in 2016, however, 45 percent did so.
Among the companies turning to COEs are General Electric Co., Wal-Mart Stores and Lowe’s Cos., which have partnered with hospitals to design COE programs as a way to keep a lid on the cost of healthcare benefits. The article cites the National Business Group on Health as predicting an overall cost increase of 6 percent for health benefits in 2017.
Among employers not using COEs, 32 percent say they plan to provide their employees access to them by 2018. But even those who already use them aren’t giving workers much incentive to actually use them; only 17 percent reduce employee cost-sharing for getting medical care at the center. That said, 54 percent of employers said they may start reducing cost-sharing by 2018.
Another rising trend is the use of narrow networks that include high-quality doctors with lower costs for services. Champions of these “high-performance networks” say they differ from the old HMO networks, which cut out the most expensive doctors without paying attention to quality ratings.
The survey found that the number of employers using high-performance networks has nearly doubled to 20 percent from 2015’s level of 11 percent; in addition, 39 percent of respondents say they may add high-performance networks in the next three years. Among employers that have already added high-performance networks, about 50 percent cut employee cost sharing for in-network care.
Some employers are considering going directly to the providers, too, to get a better rate; 16 percent of respondents are considering contracting directly with COEs, accountable care organizations and patient-centered medical homes. Only 8 percent do so at present — and a National Business Group on Health survey released in August found that just 4 percent or less of very large employers contracted directly with COEs for medical services; most went through the health plan instead.