Employers Use of Center of Excellence Programs as a Pathway for Behavioral Health Services

(By Nirmita Panchal, Matthew Rae, and Kaye Pestaina for the Kaiser Family Foundation Published: Dec 08, 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 program. KFF’s 2023 Employer Health Benefits Survey asked employers about the COE programs included in their largest plans, including those focusing on behavioral health services (these include mental health and substance use disorder services). Continue reading here…

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