Centers of Excellence

The Centers of Excellence (COE) Program offers knee and hip replacement surgery and spine care for low to no cost to qualifying Uniform Medical Plan (UMP) members.

Premera Blue Cross administers the COE Program for UMP. For more information about the COE Program, visit Premera's COE Program website, read the COE Program brochure, or call Premera at 1-855-784-4563 (TRS: 711).

COVID-19 update: Premera is accepting intakes for new patients for the COE Program. The COEs, Virginia Mason Medical Center (Seattle) and MultiCare Capital Medical Center (Olympia), are now scheduling elective surgeries. Both facilities are following strict protocols to ensure patient and staff safety. Virtual visits may also be an option for some COE appointments.

Learn more about this benefit.

Why create the COE Program?

The Washington State Health Care Authority (HCA) works to provide high-quality health care at the lowest possible cost to our members. The COE Program is part of HCA's continued efforts to pay for value instead of volume.

Through the COE Program, HCA contracts with providers who excel in treating certain medical conditions. These providers are selected to be a part of the COE Program because they have proven their ability to provide excellent service with successful results for patients with those conditions.

Virginia Mason Medical Center is the COE for knee and hip replacement surgery. MultiCare Capital Medical Center and Virginia Mason Medical Center are the COEs for spine care. Premera Blue Cross administers the COE Program.

UMP Classic, UMP Select, UMP CDHP, UMP Achieve 1, UMP Achieve 2, and UMP High Deductible members who meet medical and other criteria described below can receive their treatment, including pre- and post-surgical care, at low to no cost. The Program also includes a travel and lodging benefit for eligible expenses.

Learn more about the COE model
  • The COEs use evidence-based best practices as recommended by the Bree Collaborative.
  • The COEs assume financial risk for preventable surgical complications and infections.
  • The COEs' clinical teams – including physicians, hospitals, and others involved in coordinating patient care – keep the member involved in every step of the decision-making about their care choices.
  • HCA reimburses the COEs in what is called a "bundled payment," one sum for the entire episode of care, including diagnosis, surgery, and rehabilitation.
  • HCA reviews the quality of care given to its members by the COEs.

COE results

HCA began offering the COE Program for single knee and single hip replacement to qualified UMP members on January 1, 2017. HCA's success with the COE Program is highlighted on the New England Journal of Medicine's blog, Catalyst.

How to get started

The COE Program is open to UMP Classic, UMP Select, UMP CDHP, UMP Achieve 1, UMP Achieve 2, and UMP High Deductible members who:

  • Are 18 years or older.
  • Are not enrolled in Medicare as their primary coverage.

Members interested in participating in the COE Program may refer themselves, or their regular providers may refer them, by calling Premera at 1-855-784-4563 (TRS: 711).

Once referred, Premera will assist members in gathering their records so that the clinical teams at the COE can determine if the COE Program is right for them. Members may be required to follow a plan of care the COE gives them as a condition of approval for treatment.

Visit Premera's COE page for more information about the program's clinical review requirements.

Contact

Premera Customer Service
Online:
Premera's COE Program
Phone: 1-855-784-4563
TRS: 711
Business hours: Monday through Friday 7 a.m. to 5 p.m. (Pacific)