How Collaboration with Centers of Excellence Enhances the Primary Care Experience

If you or someone you care about has ever been diagnosed with a complex, serious, or rare medical condition, then you know how difficult it may be to process this news and navigate next steps. In such moments, the role of your care team becomes even more crucial: how will you make these complicated decisions about your health? What care is necessary to achieve the best outcomes? What will getting this condition under control look like?

One of the major roles of a primary care provider (PCP) is to be a gateway to the broader healthcare ecosystem and help coordinate specialty care when necessary. In cases like this, it’s important they collaborate with the right specialists to help deliver the proper care and guidance as accurately as possible. Through collaboration with Centers of Excellence, PCPs treating members with complex chronic conditions have the support of some of the best specialists in the country for expert second opinions and referrals when medically necessary. This blog will explore the impact of this collaboration on the primary care experience for members.

When a member is diagnosed with a serious medical condition, they might feel overwhelmed at the thought of what to do next. In a traditional healthcare setting, the PCP may refer them to a specialist, but after they leave the appointment, it can feel like they’re left to navigate the journey of specialist care on their own. However, when organizations collaborate with a Center of Excellence, the PCP takes the extra step of connecting with specialists on the members’ behalf. By receiving an expert second-opinion, the provider gets confirmation of the diagnosis and can better understand and communicate proper next steps of care for the member. The member can rest assured that any referrals and additional care going forward are recommended by experts in the field, and that their PCP will be there every step of the way.

At Premise Health, we collaborate with the nationally acclaimed Mayo Clinic for our Centers of Excellence approach. Shaw Industries, a leader in flooring solutions and a Premise Health client since 2019, has seen great outcomes through this solution. For the first six months of 2024, eight members from Shaw were referred to and traveled to a Mayo Clinic campus for support with their condition. On average, each member saw three specialists, where 75% of the members had a change in their diagnosis, and all had a change in their treatment plan. For those eight members and their PCPs, that referral was essential to receive the most accurate diagnosis and effective treatment.

For one of Shaw’s members, a routine colonoscopy for their significant other uncovered both a tumor and another serious condition:

“In December, while removing the tumor, more cancer was discovered. Both types [were] very rare: neuroendocrine and endometrial stroma cell carcinoma…” the member recounts. The couple immediately sought additional medical guidance and took advantage of Centers of Excellence through Premise. After being referred to the Mayo Clinic in Jacksonville, Florida, the specialists conducted several tests and began the proper treatment.

This powerful story is one of many where this collaboration has provided potentially life-saving diagnoses and treatment to members and their dependents.

In many circumstances, the relationship between a member and their PCP is the foundation for their long-term health and wellbeing. In fact, a continuous relationship with the same primary care provider has been associated with a lower risk of long-term illness and reduced mortality rates. When it comes to rare diagnoses, members should never be alone – they should have the support of experts through Centers of Excellence in addition to their PCP that they know and trust. An ideal Centers of Excellence and primary care collaboration also shares the same electronic health record, meaning care coordination is seamless. When their care team is in sync, individuals feel more supported every step of the way.

See how this seamless support made all the difference for a Premise Health member faced with a rare diagnosis:

Proper preventive care means catching issues early. In the past 25 years, it’s estimated that Americans have gotten at least 12 million more years of life due to preventive cancer screenings, which adds up to at least $6.5 trillion (about $20,000 per person in the US) in economic impact. When members get an accurate diagnosis for a complex condition early, they can start the right treatment quickly before the condition worsens and gets more costly. This helps eliminate cost inflators like duplicative services, unnecessary tests, and delayed treatment, which saves on medical spend, and has the chance to extend lifespans dramatically by getting members healthier faster.

With the support of Centers of Excellence specialists, PCPs can be certain they are setting members up for success, both clinically and financially, even for conditions that may be outside of their scope-of-practice.

A Shared Commitment to Excellence

In May of 2019, Premise Health announced a collaboration with Mayo Clinic to enhance care delivery for our members and their families through a Centers of Excellence approach. In the years since, our team-up has helped deliver better health outcomes, improve the member experience, and lower overall healthcare cost through PCP collaboration with Mayo Clinic’s premiere specialists. But more than that, this has allowed our clients to offer an invaluable resource to members faced with a complex or rare diagnosis.

Read more about primary care and our Centers of Excellence solution at Premise Health or contact us today.