KFF Health News December 8, 2023
A growing number of employer-sponsored health plans use Center of Excellence (COE) programs as a way to provide enrollees with specialized care for selected health services. COE programs designate providers or facilities based on cost and quality of the care they deliver. Providers participating in COE programs often specialize in selected services, and may provide additional case management and other support services for patients. Participating providers may be chosen based on the outcomes they achieve, such as lower readmission rates, or because they have earned additional accreditations. Plans vary in how they structure their COE programs, with some plans limiting coverage to providers participating in the COE, and others providing lower cost-sharing for enrollees to use a provider within the...
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