Cost managed, quality healthcare program for employers.
The Centers of Excellence Program (COE) offers long-term value by providing high-quality care and superior outcomes.
At the same time, our rigorous triage may be able to help you avoid unnecessary costs by eliminating unnecessary surgery. Finally, COE reduces costs by offering preferred rates and predictable pricing.
The value of our program is demonstrated in several ways. First, we are able to treat the most complex patients and provide a quality outcome. Employees seen through the COE program have dramatically lower complication and readmission rates.
This results in a superior experience for the employee and a quicker return to work, which carries a long-term impact. Employers have also realized savings due to cost avoidance, a benefit of our group practice model. With a staff of salaried physicians, there is no incentive to recommend unnecessary treatments.
Employers can feel confident that their employees are following the correct, and most cost-effective treatment path.
Managing Healthcare Spending
The Right Patient
Cleveland Clinic has experience treating the world’s most complex heart conditions, and that is where employers see the most value in our services. Cleveland Clinic assists the employer with identifying complex procedures, those most likely to drive up costs. Only patients with these pre-selected conditions are eligible for COE.
The Right Diagnosis
As Incorrect diagnosis can drive unnecessary care and cost. Up to 25% of the cases we review result in a modification to the diagnosis or treatment plan. In addition to COE, Cleveland Clinic offers MyConsult – an online program for obtaining a second opinion. Employees can access the MyConsult program to obtain a second opinion for more than 1,200 diagnoses.
The Right Treatment
Cleveland Clinic’s employed group practice model ensures appropriate and necessary treatment. We are committed to quality and publicly share our surgical outcomes annually. Employers who work with us know that we are committed to providing a superior patient experience resulting in the best possible outcome.
The Right Location
By focusing on the most complex cases, COE allows employers to provide access to top care for employees who need it most while containing costs. Patients are seamlessly transitioned back home with continuous monitoring and communication with their home market physician.
Centers of Excellence Program Process
A supplemental carve-out benefit for your employees and beneficiaries, the Centers of Excellence (COE) is a turnkey program — from marketing and communications, to eligibility, concierge treatment and payment — that eliminates any operational challenges. Qualified patients have their co-pay and deductible waived, and all travel costs (including companion) are covered.
Benefit Design & Availability
In order to provide an appropriate incentive to access the Cleveland Clinic National Network for care, the benefit waives all applicable co-pays and deductibles the employee would have faced if they accessed care through their underlying benefit plan. This leads to $0 out-of-pocket cost for qualifying services, whereas out-of-pocket expenses for normal coverage could reach thousands of dollars for most of the qualifying procedures. The benefit is typically available to all employees that participate in an employer-sponsored plan.
We provide patient advocates with expertise in the complexities involved in coordinating travel and executing the logistics necessary for accessing care away from home. Through our program, the employer covers all travel coordination, travel-related expenses for the employee and companion; including airfare, ground transportation, hotel and a daily per diem for meals and incidentals. By providing this full benefit package, the employer removes any financial and logistical barrier an employee may face in accessing top quality care from the Cleveland Clinic National Network.
While receiving care at a Cleveland Clinic National Network facility, a care management team—consisting of a patient advocate, nurse and transitional care specialist—is assigned to provide care management services across both the event and post-discharge. This team is responsible for communicating follow-up care plans and coordinating the patient’s return to their local market. Our goal is to provide a coordinated care experience that begins well before the patient arrives at the facility and follows their progress after they’ve settled in at home.