Centers of Excellence for Employers: Your Guide to Choosing the Right COE Model

Centers of Excellence (COE) provide employees access to life-changing care and give employers a real opportunity to reduce ever-rising healthcare costs. That’s why 84% of companies currently have a COE in place for at least one condition area, according to Business Group on Health’s 2026 Employer Health Care Strategy Survey.

But having a COE isn’t the same as having one that works. Utilization is a persistent challenge. Awareness tends to be low, traveling for care is hard even with financial incentives and local options can be limited. On top of that, there’s no standard definition of “excellence” across the industry, making it genuinely difficult for employers and employees to compare and understand their options.

As employers look to expand their COE offerings to cover additional procedures, choose a different solution or implement a COE for the first time, it can be challenging to understand the differences between vendors and how they measure quality. This guide will give you the confidence to find the right solution for your employees and the opportunity to improve outcomes while finding significant savings on your healthcare costs.

What Are Centers of Excellence?

A Center of Excellence is a curated network of healthcare providers and facilities that delivers high-quality, cost-effective care for complex or expensive procedures, most often surgery, cancer treatment and infusions.

The idea is simple: instead of leaving members to navigate a broad, uneven provider network alone, a COE steers them toward providers who consistently deliver strong outcomes for a specific condition. Done well, that benefits everyone. Members get better care and often a smoother, more affordable experience. Employers see less complications, fewer unnecessary procedures and lower downstream costs.

The right COE model should fit your workforce and consistently steer employees to the highest-quality providers and the right facilities. Once you understand the three main types of COE models, it’s much easier to compare vendors on an apples-to-apples basis.

Before You Evaluate a COE Vendor, Know Your Own Numbers

The right COE solution can meaningfully improve employee health and lower costs, but only if it fits your organization’s specific needs. Before you start conversations with COE vendors, work with your team to understand your requirements and brainstorm questions to lead the conversation.

• What are the biggest drivers of healthcare costs at your company? Musculoskeletal pain, orthopedics, bariatric care and cancer tend to top the list for most employers, but it’s worth looking at total surgery spend as a whole, not just by condition.
• Where does your population currently get care? Are your employees concentrated in a major metro area with several health systems, or spread across healthcare deserts where a 100-mile drive to a specialist is normal?
• What does your current vendor ecosystem look like, and how well do those vendors currently coordinate to drive outcomes? Does your organization juggle multiple, disconnected point solutions that overburden employees or deliver minimal impact.
• Is health equity a factor in your population? In addition to access, do you have a large percentage of people who don’t contribute to their HSA, or are there other social determinants of health issues that create a barrier?
• What care quality issues are you already seeing? Are employees experiencing surgical complications or readmissions you want a COE to help address?

Once you’ve got a handle on your own data, more in-depth vendor conversations tend to fall into three buckets:

1. Questions to ask COEs about their Network: 

• How many surgical facilities and how many surgeons are in your network?
• Where are your facilities and surgeons located in relation to where my employees live and how far will they need to travel for care? Can you provide a geo-analysis?
• Do you empower the surgeons in your network to operate at the most appropriate, qualified site for the patient, whether that be at a hospital or ASC?
• How do you thoughtfully and sustainably grow the surgeons or facilities in your network?
• Does the vendor cover all plannable procedures, or only high-risk categories like ortho, joint, spine and bariatrics?

2. Questions to ask about Quality of Care:

• What qualifications do surgeons have to participate in your COE and do you individually vet all specialists and facilities? How often are they vetted?
• Do you have the same rigorous quality standards for every facility and specialist in your network for equitable access and best outcomes?
• If your COE covers multiple specialty care categories, how do you measure quality standards across your network for different procedure types and conditions?
• How do you measure whether a procedure was medically necessary, not just whether it was performed well?
• What is the complication rate for procedures performed by your network providers?
• How do you communicate quality to members?

3. Questions to ask about COE Engagement & Utilization:

• What are your plan design recommendations to encourage or require utilization (mandatory vs. elective)?
• How will you help me communicate to employees that this program is available?
• Is the communication personalized and targeted to members’ care needs?
• What are your utilization results for voluntary and mandatory plan designs?
• How do you drive utilization for voluntary plans?
• What integrations do you have in place with other vendors or point solutions to  drive utilization? How many procedures per thousand enrolled employees do you provide annually?
• If an employee does need to travel for care, what assistance can be offered?

Ryan McCracken, Director of Benefits at a financial services firm with 80,000 eligible employees, says they needed to lower healthcare costs while helping members get the best care. They began looking for a COE solution to help and in 2025 selected Lantern for its ability to deliver both high-quality care and convenient access.

“It was very important for us that we could easily link our members up with providers who were going to give them the best possible care for them in the location that worked for them if they needed to travel,” McCracken says. And in the first six months alone, the firm saved $1.4 million. “This is huge for us,” he adds. “This is one of those rare win-win types of scenarios.”

Types of Centers of Excellence at a Glance

As you research your options, you’ll typically run into three main COE categories.

Source: COE Buyer’s Guide for Employers

Challenges and Considerations for Evaluating Centers of Excellence

Most large U.S. employers now offer a Center of Excellence (COE) for at least one condition. According to the 2026 BGH survey, bariatric surgery (71%) and musculoskeletal care (56%) are the most commonly covered specialties.

At the same time, COEs have an awareness issue both among HR leaders and employees. In a survey conducted by Kaiser Family Foundation, 13% of large firms with COE programs didn’t know what condition areas they covered. This finding is telling: if HR leaders aren’t aware of the details of their COE, chances are utilization isn’t particularly high and the overall impact of the program has been small.

As you evaluate COE solutions, watch for a few common pitfalls that can limit quality, reduce employee engagement and erode potential savings.

Challenge: What Does “Excellence” Actually Mean for COEs?

Quality is the most important element of any COE program, but who determines how quality is defined? There isn’t a standard, industry-wide definition. Research on the topic, including a study associated with the University of Pennsylvania School of Medicine, found significant variability in how COEs are defined, and noted quality metrics are difficult to measure.

When researching your options, a few questions can help you assess how a program makes its designations:

• What qualifications do surgeons have to participate in the network?
• How does the COE assess surgeon experience for each condition?
• What is the complication rate for your priority procedures

Most traditional, and even some independent COEs, are still evaluated at the facility level rather than the surgeon level, even though surgeon expertise can vary widely within the same well-known facility. Research suggests that not all Centers of Excellence perform equally, and key measures of surgical appropriateness vary widely from one COE hospital to another. It’s worth asking any vendor you’re evaluating how they control for that variance.

Challenge: Lack of COE Utilization

COE utilization is often low when employees don’t have easy access to local care. This is especially true for facility-specific COEs, where all employees seeking a given procedure have to travel to one designated hospital.

Lantern analyzed data from a long-time partner and found utilization was 8x higher in metro areas where members could be placed locally, compared to metro areas where they had to fly to access care.

A COE with a track record for high utilization commonly prioritizes:

Care Navigation & Support 

• Offers personalized support to guide employees through the process
• Uses proactive outreach to identify and engage eligible members
• Simplifies referrals and reduces steps to access care
• Provides strong follow-up care and recovery planning
• Helps employees navigate post-procedure support and benefits

Communication & Promotions

• Leads the promotions strategy
• Uses plain, accessible language in all materials
• Actively promotes the program year-round, not just during open enrollment
• Clearly explains how the COE improves health and saves money

Ease of Access 

• Offers nationwide coverage at a variety of hospitals, ambulatory surgical centers and other health centers
• Covers travel, lodging and logistics expenses
• Minimizes wait times and offers flexible scheduling

Measurable Impact

• Tracks employee utilization and satisfaction in real time
• Adjusts program design based on employee needs
• Reports on outcomes and cost savings transparently

When introducing Lantern to employees, Kim Baker, Senior Advisor of Health and Welfare Benefits at an energy manufacturer, faced a unique challenge: reaching field workers at the company’s refineries. Knowing traditional communications wouldn’t be enough, Baker partnered with Lantern to develop a strategy tailored to that audience.

“The Lantern marketing team knocked it out of the park,” Baker says. “They came up with a crossword puzzle to put in the bathrooms to get people to understand, ‘Hey, you’ve got a benefit.’ While that didn’t work at our corporate facility, it absolutely worked in the field.”

Questions to Help You Measure COE Utilization

These questions can help you understand how each COE solution drives employee utilization and where adoption may fall short. Whenever possible, ask vendors to share real client examples and performance data rather than relying on high-level claims.

• How will you help me communicate the value of the COE to employees?
• What are your plan design recommendations to drive utilization?
• Does your COE cover all plannable procedures?
• Does your network design require employees to travel for care?
• What travel assistance do you offer?
• What integrations do you have in place with other vendors to drive utilization?

A note on equity: The right COE solution can also support a company’s DEI goals by making high-quality care accessible regardless of geography or income. An inclusive COE program should be accessible across geographies, inclusive of as many procedure types as possible, affordable (waiving co-pays, deductibles and co-insurance) and conscious of health literacy with guided, bilingual support.

Consideration: Member Experience

Healthcare is difficult to navigate, and the stress of facing surgery or cancer only makes it more overwhelming. Cost savings and access matter, but members also need ongoing support to schedule appointments, understand their costs, coordinate follow-up care, and manage travel. Without that guidance, even the best-designed COE program may go unused.

When assessing a COE for member experience, useful questions include:

• How easy is it to reach member services, and what are their hours?
• Will employees get help scheduling appointments and travel arrangements?
• How do members rate the quality of support they receive?
• Can the vendor share testimonials or feedback tied specifically to member experience?

“Over 50% of our members have come to utilize Lantern because they’ve heard from another employee who’s had such a positive experience that they let members know that they need to look at this, rather than going through the traditional process to seek surgery. That statistic in itself speaks to how well the care advocates take care of our members and how positive that member experience is,” says a benefits manager at a leading insurance company.

Consideration: Cost Savings Models

A COE can reduce healthcare costs in several distinct ways, and some are easier to measure than others. In vendor conversations, you’ll likely hear reference to these four methodologies:

Why Choose Lantern’s Specialty Care Platform?

The right specialty care platform doesn’t ask employers to choose between quality, access and savings. Lantern is built to deliver all three, while supporting employees from their first call through recovery.

• We build our network at the surgeon level: We certify all surgeons at the individual level using a quality check. Our surgeons deliver best-in-class outcomes with complication rates nearing zero across all plannable surgeries.
• Our network includes national and local care: 99% of members receive high-quality care within a 40-mile drive from home.
• We provide concierge guidance to every member: Lantern’s Care Advocate team provides individual support to every member.  On average, a member will have their consultation scheduled within 22 days of their first call.
• We deliver meaningful savings: Our rates run 55%+ lower than carriers on average, with bundled pricing covering the facility, surgeon and anesthesiology charge.

Why More Employers Are Turning to Cancer Centers of Excellence

An increasing number of employers are looking for COE support beyond traditional surgical condition areas, expanding into cancer.

According to Business Group on Health, 73% of large employers planned to have a cancer COE in place by 2027-2028, up from 49% in 2025.

Around 40% of people will be diagnosed with cancer during their lifetime. Cancer rates are also rising among younger adults, though researchers still don’t fully understand why.

The U.S. now spends more than $200 billion each year on cancer care, making it the largest driver of healthcare costs for 86% of employers. While breakthrough therapies continue to improve outcomes, the price of new cancer drugs continues to outpace inflation.

Cost is only part of the challenge. From diagnosis through treatment and survivorship, the cancer journey is often overwhelming to navigate. A woman with breast cancer may encounter more than 30 healthcare touchpoints before receiving her first treatment. Without dedicated support, employees are often left to navigate one of the most complex experiences of their lives on their own.

Cancer care differs from surgical care in a few important ways worth understanding before applying a surgery-style bundled model to it:

• Cancer is longitudinal, not episodic: Treatment can last months or years, while bundled pricing tends to make more economic sense for episodic care like surgery.
• Bundles usually only cover less-complex cancer cases: Ideally, a solution provides support for all types and stages of cancer. Cancer bundles typically focus on less-complex cases.
• Bundles may not be as effective at managing costs and improving care for cancer as they are for other conditions: Where you receive care matters, but much of cancer care can and should be delivered locally. Bundles, on the other hand, frequently require prolonged treatment to be delivered at a specific site.

Today’s cancer patients have a better chance than ever before of living longer and healthier lives. Those improved outcomes are also a major reason cancer care costs continue to rise.

“We’re starting to see more and more, particularly with immunotherapies, these longer courses of treatment of maintenance immunotherapy to try to keep the cancer under control, which I think is also adding to the cost burden,” says Yousuf Zafar, MD, MHS, Chief Medical Officer at AccessHope.

The Lantern Approach to Cancer Care Management

Lantern’s approach to cancer care centers on three things:

• Care for everyone: 100% of cancer patients are eligible for support.
• National and local care: Members can access national comprehensive cancer centers or community care centers depending on what’s clinically appropriate.
• Meaningful cost reduction: Lantern reduces cancer costs through higher quality care and reduced waste, such as optimizing site of care and reducing ER visits through expert support.

Lantern’s Exclusive Partnership with AccessHope

Lantern is the only end-to-end program that combines oncology nurse-led navigation, community-based site-of-care optimization and always-on NCI-level clinical oversight through an exclusive partnership with AccessHope.

Where AccessHope brings subspecialty expertise to the treatment decision, Lantern ensures that expertise reaches the member and stays with them across the full arc of care. Each member is supported by a dedicated care team led by an oncology nurse with an average of 16 or more years of clinical experience, alongside a licensed clinical social worker and a care advocate managing insurance, appointments and logistics.

Lantern’s site-of-care model addresses cost and access challenges simultaneously. Hospital-based cancer care costs 50% more than equivalent community-based care, and members receiving treatment in hospital outpatient settings pay $55,000 to $81,000 more per patient per year than those treated in physician office settings. Lantern navigates members to the highest-quality care available close to home, and for members who require specialist-level intervention, facilitates access in under 10 days.

The result is a model in which community-based care and NCI-level oversight are not alternatives but complements: the member doesn’t have to choose between proximity and clinical precision.

To learn more about Lantern’s approach to cancer care, see The Employer’s Modern Guide to Cancer Care Benefits.

Lantern Infusion Care: A Better Way to Manage Specialty Spend

Infusion therapy is one of the fastest-growing drivers of specialty healthcare spending, accounting for about 10% of total spend.

Infusion therapy includes hundreds of high-cost medications used to treat complex conditions, such as:

• Cancer
• Autoimmune diseases
• Neurological disorders
• Rare diseases

A major reason infusion costs vary so widely is where employees receive treatment. Hospital outpatient departments often charge significantly more than independent ambulatory infusion centers or home infusion providers for the same medication and clinical care. When clinically appropriate, steering members to high-quality community infusion centers or home infusion can reduce costs by 40% or more, while delivering outcomes that meet or exceed hospital-based care for many patients.

Lantern Infusion Care helps employers optimize site of care by connecting members with accredited community infusion centers or home infusion providers when appropriate. Each member receives personalized support from a clinical care team that coordinates appointments, answers questions about medications and side effects and works with the treating physician to ensure a smooth transition. The result is lower costs for employers, a more convenient experience for employees, and the confidence that members are receiving care in the right setting for their clinical needs. Those benefits led Hyatt Hotels to add Lantern’s infusion program in 2025.

“We were looking, one, for an opportunity for financial savings, but also to give our colleagues an opportunity to make sure that they were getting the appropriate care at the right place,” says Dawn Beaudin, Vice President, Benefits, Hyatt Hotels. “The infusion program gave us an opportunity to take those infusion medications out of the hospital settings, out of the provider settings where they’re marking up the cost of those infusion medications, but also give our colleagues an opportunity to have it done more locally or even at their homes.”

Key Takeaways

As more employers expand their Centers of Excellence programs, choosing the right solution has never been more important. These considerations can help you lower costs, improve outcomes, and deliver a better experience for employees.

• There’s no one definition of “excellence.” Ask questions that get at how each COE solution measures quality and decides which facilities and surgeons to let into its network.
• Improving utilization takes strategy. Consumers like choice and limiting it can be a tough sell. Ask vendors how they overcome barriers to utilization and incentivize members to actually use the COE.
• Significant savings are possible, but it matters where they come from. Ask COE solutions how they calculate cost savings and what percentage of those totals reflect true hard-dollar savings versus softer, harder-to-verify figures.

“The value Lantern brings to employers and members is helping them access the care they need in the moments that matter most. For us, that’s surgery, cancer, and infusions. Some of the highest costs, scariest moments that members go through. We help them access the best quality care at affordable prices and bring down the overall cost of healthcare for employers in the United States,” says John Zutter, Lantern CEO.

Ready to Support Your Employees in the Moments That Matter Most?

Get in touch for a conversation about how Lantern can help your organization improve outcomes, cut costs and make a real difference in your employees’ lives.

Related reading: What is an Independent Center of Excellence? | The Top FAQs About Next-Generation COEs | Independent COEs vs. Health Plan COEs: What’s the Difference?