United States Medical Centers of Excellence

A government-defined Center of Excellence, beginning in the mid-1960s, is a facility or organization that creates healthcare value above the average found in a specific location. In the late 1990s, the US Health Care Financing Administration (HCFA) began to examine and compare treatment outcomes among hospitals paid by Medicare. Other division of government as well as the private sector, have developed their own systems for rating and/or developing Healthcare Centers of Excellence.

For information and background on Medicare Centers of Excellence, click the link.

EXAMPLES

The United States Federal Government established national centers of excellence in health care in the 1990s through their Department of Health and Human Services. Since that time, other new systems of Centers of Excellence have emerged, including a system of medical centers under the supervision of the US Veterans Administrationand a system developed by insurance companies, specifically Cigna HealthCare. Other systems exist as well and the healthcare consumer is wise to investigate the history, development, and certification rationale for any medical or healthcare "center of excellence." They are not all the same.

Cigna offers a brochure designed to help patients select the healthcare most approrpiate and most affordale to themselves. It is named

CIGNA HealthCare Hospital Value Profile Tool and Centers of Excellence:

https://secure.cigna.com/health/provider/medical/pdf_coe.pdf

CIGNA CENTERS OF EXCELLENCE

The Cigna selection process for "excellence" is based on a scoring system that looks at 1) postive patient outcomes and 2) cost effieiency in treatments offered in 19 separate healthcare categories in hospitals and medical centers. The system also awards these healthcare institutions with an overall score,

Individuals insured with Cigna are granted access to check individual hospital scores per treatment category and overall at the CIGNA Hospital Value Profile Tool at the company website. Patients may then choose the Cigna Center of Excllence that feel is best for them or select a medical center or hospital thatis not a Cigna Center for Excellence.

This all is a little like the AAA recommended (AAA Certified) auto repair shop program and can help healthcare consumers in a manner similar to the help given auto repair comsumers.

The impressive Veterans Administration system of Centers of Excellence (COE) is well organized and seems designed to provide and to further develop the most accurate, results-driven, up-to-date, and efficient healthcare solutions to American Veterans. This system is for US veterans.

Every one of the separate centers develops a unique research agenda. All are connected with a local VA Medical Center. Each COE partners with local Schools of Public Health and universities/medical-healthcare colleges.

The US Health Services Research and Development Serivice develops and oversees the federal Centers of Excellence program conencted with the Veterans Administration. A list of centers current in 2010 follows, arranged according to national region.

HSR& D Centers of Excellence

East

• Bedford MA - Center for Health Quality, Outcomes, and Economic Research
• Boston MA - Center for Organization, Leadership and Management Research
• Pittsburgh/Philadelphia PA - Center for Health Equity Research and Promotion

MidWest

• Ann Arbor MI - Center for Clinical Management Research
• Hines IL - Center for Management of Complex Chronic Care
• Indianapolis IN - Center of Excellence on Implementing Evidence-Based Practice
• Minneapolis MN - Center for Chronic Disease Outcomes Research

South

• Durham NC - Center for Health Services Research in Primary Care - This is a most interesting center and program, lending additional impetus to the development of new products, services, and jobs arising from the large local Research Triangle of North Carolina. Telemedicine is one of the innovations under examination in 2010. Chronic conditions, communications, cultural influences, and healthcare system efficiency are all targeted topic in this COE.   
• Houston TX - Houston Center for Quality of Care and Utilization Studies
• Little Rock AR - Center for Mental Healthcare and Outcomes Research
• Tampa FL - Maximizing Rehabilitation Outcomes

West

• Palo Alto CA - Center for Health Care Evaluation
• Seattle WA - Northwest Center for Outcomes Research in Older Adults
• Sepulveda CA - Center for the Study of Healthcare Provider Behavior

For additional detailed information and individual websites for the above 14 COES, please visit

US VA CENTERS OF EXCELLENCE

Minority Health COE facilities are a separate set of healthcare institutions recognized by the National Center on Minority Health and Health Disparities. These centers have been developed to aide in an American, Puerto Rican, and US Virgin Island inititiative to find and fix healthcare delivery disparities that result because of patients' age, gender, race, ethnicity, and other demographics; and, to encourage wider spread cultural competency in delivering healthcare services.

Since 2002, the NCMHD has established 88 Centers of Excellence. The program initially had three categories: Resource Related Centers (discontinued), Exploratory Centers and Comprehensive Centers. The use of these three different funding mechanisms allowed NCMHD to help level the playing field among institutions with varying experience in biomedical research and to leverage the different skills and capabilities of the nation's geographically and culturally diverse institutions.

From 2002 to early 2010, the NCMHD developed 88 Centers of Excellence and partnerships with local higher education (inlcuding the traditionally Black and tribal) in 31 US States, Washington DC, Puerto Rico, and the US Virgin Islands. 

 In 2007, the NCMHD COE program established 12 new exploratory and comprehensive COEs and continued support for 25 previously funded NCMHD COEs.

For additional information about the COE and other progams, clink the link.