Policy Examples

• Health care institutions that offer exceptionally high expertise in a particular field of medicine, known as Centers of Excellence (COE), promote network efficiency and are growing in use, especially in areas like cancer and fertility care. source

Outcome Evidence

• According to the 2019 National Business Group on Health survey, 35% of employers offer high-performance networks or Accountable Care Organizations (ACOs) and another 23% are considering implementation for 2020/2021. source & source
• In 2017, The Puget Sound High Value Network, saw 66 percent growth in enrollment over 18 months, raising their total number of enrollees to 14,895. Network reported 40 percent fewer admissions compared to Washington providers in fee-for-service health plans. source
•  Among the plans being offered in states that use HealthCare.gov, 72% are narrow, meaning they have fewer providers in the network and require members to seek care from those providers to obtain coverage. source
• Despite the lack of choice, in general, consumers are selecting narrow networks with increasing frequency and tend to be satisfied with their choices. source
• In 2012, Walmart announced their COE program offering employees full coverage for costly procedures at partner sites. As of 2019, 5,000 Walmart employees have participated in the program, and more than 95% said they were "satisfied" or "very satisfied". Between 2015 and 2018, the employees who had joint replacement surgery at a COE site spent 32% less time in the hospital and were 70% less likely to be readmitted than those who had the surgery elsewhere. Further, the cost per case of joint replacement surgery was approximately 15% less at COE sites compared to non-COE site. source, source, & source