5 Common Myths & Facts everyone should know!
A recent survey shows that 92% of large U.S. companies offer a healthcare Center of Excellence (COE) for at least one condition—but many benefits leaders report low employee engagement. While COEs can drive better health outcomes and cost savings, not all models deliver the results employers expect.
Lantern’s VP of Strategic Accounts, Mike Cook, and Chief Network Officer, Ryan Burke, share how Lantern’s surgical Network of Excellence differs from traditional carrier COEs. Here, they address common misconceptions and present a new approach to COEs that boosts both accessibility and engagement.
Myth #1: health plan centers of excellence are your only option
Most employers rely on their health plan to provide a COE. While the barrier to entry is typically low, this model has significant limitations. Health plans often can’t steer members to specific facilities, dampening employee navigation and reducing utilization. And employees may not even be aware the COE exists if the carrier doesn’t promote it.
An emerging alternative is the “independent COE”—a solution designed around providers rather than specific facilities or carrier relationships. Because these COEs aren’t restricted to one hospital system, they can curate national networks of top-tier surgeons operating in diverse care settings and proactively guide employees to those high-quality providers.
Myth #2: all surgeons in a coe operate at the same level
Facility-based COEs give employees access to all providers within one location, regardless of individual expertise, specialization, or experience. “All centers of excellence are not created equal,” says Cook. “Even in a renowned hospital, surgical skill can vary widely.”
Complication rates for surgeries average 8%–15%, and almost one-third of surgeons in a given market lack board certification. Identifying high-quality care can be challenging, and employees rarely have the time or resources to vet their providers effectively.
Lantern addresses this by vetting surgeons using strict “knockout criteria” and a data-driven approach. Every surgeon must be board-certified and fellowship-trained. Lantern also assesses procedure volume, surgical safety rates, readmission rates, and the comprehensiveness of patient care plans. As a result, Lantern providers report a 99.4% recovery rate—far higher than the industry average of 85%.
According to Burke, site of care is equally important for better outcomes. When possible, Lantern guides employees to Ambulatory Surgical Centers (ASCs). These centers have 75% lower readmission rates than hospitals and a six-times lower infection rate than hospital outpatient centers.
Myth #3: a coe must be mandatory to drive engagement
Benefits leaders often want to make their COE mandatory to ensure higher-quality care, but employees can be reluctant to use providers other than those recommended by their PCP or ones they already trust.
Instead of forcing a single path, Cook recommends incentivizing employees with lower or waived copays and deductibles. This approach resonates more positively, especially when paired with a broad range of covered procedures.
Whereas many COEs focus on just a few surgical categories (e.g., bariatric or joint replacements), Lantern covers over 5,000 plannable surgeries and procedures. This breadth eliminates the “wrong door” experience for employees and fosters higher engagement. “We see the greatest engagement by providing local access, covering a wide range of services, and offering no or low out-of-pocket costs,” Cook says.
Myth #4: employees must travel long distance for high-quality care
Traditional COE models often partner with only a few dozen facilities nationwide, making it difficult for employees in rural regions to travel to those centers. Large organizations risk reduced utilization if employees perceive that excellent care is inaccessible.
Lantern, by contrast, creates a national network of top surgeons operating in various care settings, placing 99% of its six million members within driving distance of a COE. Cook explains, “Our network is five times larger than our nearest competitor—over 2,000 surgeons at 1,500 locations. That’s why 99% of our members can access care within driving distance.”
Myth #5: cost savings are similar for carrier and independent coes
Carriers often highlight discounts off “list price,” but Cook notes that these discounts aren’t always what they seem. Carriers may charge 250%–300% of the Medicare rate, while Lantern aims for about 130% of Medicare prices through direct contracts.
Lantern also negotiates more favorable rates for physicians by offering higher patient volume and expedited payments—cutting down on administrative delays and accounts receivable timelines. This has a substantial impact on cost. On average, Lantern’s clients see a 4% reduction in total healthcare spend, with savings around $17,000 per member. Multiple Lantern customers save millions each year while improving care access and outcomes. For example, Hyatt Hotels saved over $6 million on surgical costs in 2023 alone.
While traditional insurance plans provide bariatric surgery coverage, SurgeryPlus is an all-inclusive benefit offered by a select group of companies. The companies listed below are only some that offer the SurgeryPlus bariatric surgery benefits to their employees:
- American Airlines
- Delta
- Hyatt
- State Farm
- Home Depot
- CVS
- Hilton
- Autozone
Don’t see your employer listed? Talk with your surgeon or contact SurgeryPlus to find out if your employer offers the benefit.
Bettering your health may seem like a daunting and expensive task at first but it does not have to be. By using healthcare resources provided by your employer you can expect doctors who care for you and are the most trusted professionals in the industry. If you are looking for surgeons who are passionate about providing quality care for both bariatric surgery in the Austin Area, give us a call at 512-260-3444. As proud SurgeryPlus providers, you can gain access to procedures, treatments, and surgeries so you live a healthy and happier life.
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B+A Medical Center is a surgeon-owned and operated clinic offering advanced and effective bariatric and weigh-loss surgery in Cedar Park.
