Benefits leaders pour time and resources into securing top-notch benefits such as a Center of Excellence (COE) or specialty care program promising superior care, better outcomes and savings. But we all know there’s no value in launching a program if employees or members don’t use it.

When you’ve invested time and resources toward a program that doesn’t drive results, the frustration sets in—wasted time, effort, money—and then you realize it’s time to cut your losses. In fact, 76% of employer respondents to the 2025 Business Group on Health Survey, say they were either strongly considering or planning to immediately eliminate lower-utilized programs.

“Employers are struggling with point solution overload, both from a member communications perspective and governance perspective,” says Erin Tatar, SVP, Consultant Relations at Lantern. “And unfortunately, the traditional Centers of Excellence is a space where engagement has been particularly anemic.”

Before you invest in a COE solution, there are a few key questions you can ask to make sure the solution will drive the utilization you need to see meaningful savings and better outcomes:

• What is the calculation you use to measure utilization?
• Where are your facilities and surgeons located in relation to where our employees live and how far do they need to travel for care? Can you provide a geo-analysis?
• What qualifications do surgeons have to participate in your COE, and do you individually vet all specialists and facilities? How often?
• What are your plan design recommendations to encourage or require utilization?
• How will you help me communicate to employees that this program is available and is it personalized to members’ care needs?

Understand how Specialty Care Solutions Measure Utilization

When you help more employees access quality surgery and achieve better outcomes, you’ll see a greater downstream impact on cost. Finding a specialty care program that delivers high engagement, even with a voluntary plan design, is critical. If utilization is low, the potential impact diminishes, and “the juice isn’t worth the squeeze,” Tatar says. 

You can’t just ask a COE solution about their utilization results. You have to be more specific.   

“When you’re talking to surgery solutions, you want to ask, ‘What is your utilization rate of annual procedures per 1,000 enrolled employees?’ Tatar says.  For example, Lantern’s total weighted average is 10.6 procedures per 1,000, with 8.2 procedures per 1,000 employees for fully voluntary programs. “That’s delivering savings of $15 per employee per month,” Tatar says.  

Local Access to High-Quality Care Increases COE Utilization

Some COE models require members to fly to a major facility no matter where they live, but benefits leaders often don’t see the desired level of utilization to make an impact on outcomes or savings. While traveling for care might be the right answer for some patients, for the most common plannable procedures, great care is available locally or within driving distance. 

Dawn Beaudin, Vice President, Benefits at Hyatt, says local access to high-quality care was critical when looking at COE solutions. They didn’t want a program where their team had to drive hundreds of miles or get on a plane for care. 

“We really wanted a strong local network,” Beaudin says. “One of the reasons we felt comfortable introducing Lantern was that over 80% of our colleagues were within driving distance of a Lantern affiliated surgeon.” 

Ryan McCracken, Director, Benefits, for a leading financial services firm, says healthcare navigation is a constant struggle and it’s really challenging to help educate members on how to find care that’s right for them. The firm has over 80,000 plan members spread across the United States in 19,000 locations.

“We have people who live in semi-rural areas, small towns and urban environments, and we’re helping them find top-quality care with Lantern,” McCracken says. “This is huge for us.” 

The quality of care provided will also drive utilization—when employees are happy with the care they receive, they’re more likely to tell other employees. But quality can be defined quite broadly.  

Again, specificity makes a difference, so have a list ready of questions related to quality. For example, ask if they vet specialists at an individual level, what the complication rate is for procedures performed by those doctors and how they measure clinical appropriateness to avoid unnecessary procedures.  

Finally, access is fundamental aspect of quality, too, for providing equitable care. “You could have the highest quality program on the planet, but if no one can get to it or use it, it’s really not high quality,” says Jason Tibbels, MD, Chief Medical Officer at Lantern. 

Plan Design and Incentives Play a Crucial Role in Utilization

The incentives you offer make a significant difference on utilization, so make sure the solution you choose has plan design flexibility. For example, many Lantern clients waive cost share for their members. We’ve also seen an increase in required procedures through Lantern, though this approach has its pros and cons.

Sara Richards, Red Bull’s Director of Benefits, says they wanted members to get the care they needed and knew a no-cost plan would drive utilization without mandating employees use the program.

“Waiving cost share has been the number one reason this program has been successful,” Richards says. “It’s such an incredible tagline that immediately gets their attention. If you don’t waive cost share, it really takes away the momentum of the program.”

Beaudin says waiving cost share is one of the best decisions Hyatt has made, too. “We have people come to us who say, ‘I couldn’t have afforded this surgery, but I got it for free.’ And that is life-changing for them.”

When considering a specialty care solution, ask whether both voluntary or mandatory plan designs drive utilization. When you launch the program, a voluntary plan might make sense as you increase awareness, but over time, you might consider implementing a mandatory plan once members are sharing their success stories and experiences with each other. Many start by making bariatrics mandatory and add other procedures later.

Hyatt, for example, requires people to use Lantern for bariatric, spine and joint surgeries. “We decided to be fairly aggressive,” Beaudin says. “They’re expensive and also risky surgeries. Once they go to a Lantern surgeon and have the experience, the feedback all comes back really positive. It’s not always easy to deal with the escalated complaints that come our way, but I don’t regret that we did it because we’ve achieved a lot of savings and given a lot of high-quality surgical procedures to people at the same time.”

Promoting your Specialty Care is Key for Utilization Success

During a recent Lantern webinar, more than a third of benefits leaders who attended rate their communication strategies fair (32%) or poor (5%). Without a consistent drumroll about your specialty care program, don’t expect high engagement or utilization numbers.

“I think the one lesson that I learn every time we roll out any new program is you cannot over-communicate,” McCracken says. “So, explaining to members, Lantern is a part of our plan. It’s not something you enroll in. There’s no additional cost. This is something we are asking you to do and here’s the reasons why… it’s quality first. Repeat that message over and over because a lot of benefits communications can get lost in the noise.”

Lantern has an emphasis on driving awareness through communications to help members navigate the healthcare landscape. “We have a very targeted and thoughtful approach, so we’re top of mind when a member needs surgery, cancer care or an infusion,” says Shelly Towns, Lantern’s Chief Marketing Officer. “We also have targeted communication when we see claims data that indicates a member might need that care.”

Tabitha Pittman, Director of Compensation & Benefits, at Integrity says they promote their benefits through internal Wellness Connection program events and give away prizes to participants. They also have an interactive benefits portal to help employees access information about Lantern and other benefits at any time. “I have made it a point of being very transparent,” Pittman says. “It’s a win-win situation.”

Richards says Red Bull makes quarterly wellness testimonial videos from their employees to help spread the word about their benefits. “We literally see upticks in our engagement every time they send it out,” she says.

Those word-of-mouth testimonials and water-cooler conversations can really make a big impact on utilization. When considering a solution, be sure to ask COEs their patient satisfaction ratings or NPS score. “Lantern has an 85 NPS, but what’s really amazing is 50% of our procedures are driven by word-of-mouth from our members,” Tatar says.

When members hear they need surgery, it can be a scary experience, but a quality COE solution that delivers a great experience, a good outcome and savings, will drive the utilization you want to see.

“After going live with Lantern, we had an employee use it and she said, ‘This is how healthcare is supposed to be.’ It’s been tremendously successful.” Pittman says.