The Evolution of Centers of Excellence in an Era of Population Health

The shift in healthcare from focusing only on individuals to focusing on individuals and patient populations is changing how healthcare is delivered. Hospitals are moving beyond their own institutions to provide preventive care and chronic disease management in the community, and primary care physicians and outpatient settings are becoming more central players in patients' health.

Steve Moreau is president and CEO of St. Joseph Hospital.Consolidation of centers of excellence
This movement toward population health management will also affect how centers of excellence are structured, according to Steve Moreau, president and CEO of St. Joseph Hospital in Orange, Calif. Health systems may consolidate centers of excellence across their hospitals to complement population health management efforts through greater efficiency and quality, he says. "As we build our capabilities around population health, we're going to see more consolidation and more of an effort to drive patients to those facilities that can handle a larger amount of patients at a lower cost," he says.

This strategy mirrors the motivation behind increased mergers and acquisitions of hospitals and health systems — improving efficiency, eliminating duplicate services and enhancing quality. "With consolidation of providers and an emphasis on value, I believe centers of excellence are going to demonstrate their value and are going to be sustained, [but] they are going to evolve," Mr. Moreau says. "I doubt we're going to see a competitive nature of multiple centers of excellence within markets; we're going to see more consolidation within markets."

For example, Orange, Calif.-based St. Joseph Health, parent system of St. Joseph Hospital, and Newport Beach, Calif.-based Hoag completed an affiliation at the end of February. Mr. Moreau says the systems plan to leverage Hoag's orthopedic center of excellence across both systems.

Regional strategies
Consolidating centers of excellence does not necessarily refer to physical facilities, but instead to strategies and processes. Health systems may build one central, physical center of excellence with smaller sites throughout the community to provide patients with easy access to services. The efficiencies and quality will be standardized for all locations. "I believe we're going to see an approach to a center of excellence that's not concentrating all patients in one site but instead, using a center of excellence to create a set of tools and services across the continuum of care," Mr. Moreau says.

In fact, the phrase "centers of excellence" may be misleading because health systems are really developing excellent services and strategies of excellence rather than physical centers. "It can be a program of excellence leveraged across multiple sites," Mr. Moreau says. "Can you create a regional strategy to provide the [best care] efficiently at each site?"

He likens this new model of centers of excellence to franchising, which is prevalent in many other industries. A hospital's original center of excellence can spread its expertise to smaller sites across the community. This approach is more convenient for patients and could be more efficient than centralizing patients in one center, according to Mr. Moreau. "There's a reason why you see [franchises] in every other industry where you might have seen at first a more concentrated approach," he says.

Providing easy access to high-quality care through regionalized centers of excellence aligns with health systems' population health initiatives. "Everybody is scrambling right now because they fear moving to population health and think that centers of excellence will somehow become less important," Mr. Moreau says. "I believe that it will evolve. Anytime you can create alignment of the best doctors with resources for creating the best outcomes at the lowest cost — that's a winning strategy."

More Articles on Centers of Excellence:

3 Basic Steps to Begin Developing a Center of Excellence
Key Specialties Roundtable: What's in Store for Service Lines and Their Leaders in 2013?

Is Center of Excellence Investment the Silver Bullet Healthcare Has Been Looking For?

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