Looking to evaluate your centers of excellence program?

The Reform Evaluation Framework (REF) for Centers of Excellence (COE) programs evaluates the impact of a COE on costs and quality outcomes. For the purpose of this tool, a COE is a designation given to a facility or provider group for particular services or procedures based on the quality and cost of care. The impact of the COE is measured by comparing the purchaser’s members who received care at a COE to a group of the purchaser’s members who received relevant care from non-designated providers.

CONTENTS 

1. Definitions: Provides definitions of terms, cost and quality measures
2. Report – Purchaser: Worksheet for evaluating purchaser’s experience with the COE program
3. Report – Book of Business: Worksheet for evaluating vendor’s outcomes for their total book of business (for vendor or health plan-administered COEs)

By using this tool you will learn:

• How quality and cost outcomes differ for your employees who use a COE vs. a non-designated facility
• How well your members’ outcomes and experience align with the Health Plan’s broader population
• The number of procedures avoided through the COE’s second opinion consult program – if the COE program includes this feature