For a few decades now, employers have adopted Centers of Excellence (COEs). The concept is simple -- find facilities and surgeons that excel at certain complex procedures. The concept and its execution stemmed from the evidence that the volume of surgeries done was causally related to good outcomes. Purchaser Business Group on Health (PBGH) played a critical role in organizing the operationalization of COEs and the wider adoption of the model. However, that model never evolved even though the healthcare system evolved. There are two glaring limitations to the pure COE model: (1) its reductivity because only those that can travel long distances and qualify physically can get in; and (2) its scope because COEs have only covered a handful of procedures.
And yet we know that in every corner of medicine, for every condition and every procedure, there are physicians and facilities that do better than others. We also know that prices vary considerably, and that travel is a burden, often outweighing any other consideration.
That's why I'm applauding the recent release of Catalyst for Payment Reform's Value Index and encourage all employers and benefits consultants to carefully examine it, understand it, and adopt it.
While the scope is currently limited because CPR wants to make sure the model is robust and meets employer needs, it can be expanded to any condition or procedure.
The Value Index doesn't impose its values on employer decision-making, but rather lets employers determine what they value most for their employees in selecting high quality, price competitive facilities. Is it quality above all else? Is it price above all else? Is it access above all else? Or is it a blend?
XO Health Inc. is proud to have supported the development of this tool and we are using it to support employers in selecting high-value facilities for their high-volume and/or complex surgeries. We have the added benefit of a state of the art engine that manages prospective payments for these procedures (and others, totaling 150 conditions/procedures), which means we can manage COE programs tailor-made to employer needs anywhere in the United States.
#COEs #VBP
Jeffrey Hogan, Steve Schutzer, MD, Guy D'Andrea, Elizabeth Mitchell, Shawn Gremminger, Justin Leader, Mike Taylor, Jeff Levin-Scherz