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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) Classic, UMP CDHP, UMP Achieve 1, UMP Achieve 2, and UMP High Deductible 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 (Seattle) and 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.

Visit Premera's COE page

Why create the COE Program?

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

UMP Classic, 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.

  • 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 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.

Results for knee and hip replacement COE: 2017 and 2018 

  • Providers performed 166 joint replacement surgeries
  • Members from across Washington participated:
    • Members residing in eastern Washington: 23 percent
    • Members residing in western Washington: 77 percent
  • No participating members experienced complications, readmissions or surgery revisions
  • Participating members saved an average of $988.46
  • Participating member satisfaction with COE was high (scale of 1-10):
Feedback question Rating

My case manager was courteous and helpful

9.8

I felt ready for my surgery

9.6

The travel arrangement met my needs

9.3

My recovery went well

9.3

If I have another joint replacement, I would choose to use this program

9.7

I would recommend this program to family and friends

9.8

Overall satisfaction with your total experience

9.5

Member feedback on their COE experience was very positive:

  • “It was great! Within a month I was back to work and everything was great. The hospital was great, it was a four-star resort, the food was great, I slept thru the night they didn’t pester me in the night, no noises, my wife stayed in the room. I didn’t want to go home and I hate hospitals.”
  • “The whole experience has been life changing for me. I was suffering for a decade and now I’m walking two miles a night and have lost 30 pounds. My physical therapist said I’m way ahead of the curve.”
  • “It was a very good program. I’m a happy camper. The best was getting a zero balance on my hospital bill. I got the timing and doctor I wanted. I am able to walk without pain and bend my knees…”
  • “The process you took me through facilitating all the paperwork was really helpful. It helped relieve anxiety knowing the program takes care of everything.”

How to get started

The COE Program is open to UMP Classic, 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 you 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)