Do Centers of Excellence Reduce Health Care Costs? Evidence From the US Veterans Health Administration Centers for Epilepsy

In 2009, the US Veterans Health Administration created several Epilepsy Centers of Excellence (ECoE) to improve the health of veterans undergoing treatment for epilepsy. A study comparing epilepsy health care at these ECoEs and at non-ECoEs from 2009 to 2011 shows that ECoEs perform better according to some metrics (average cost for high-cost epilepsy procedures and actual cost reductions over time) and less effectively according to others (patient volume and average cost for low-cost epilepsy procedures). The study also reveals the difficulties in making cost of care comparisons across health care entities. Overall, the findings suggest that the Veterans Health Administration would benefit from a triage system that channels high-cost epilepsy procedures from non-ECoEs to ECoEs. ©2015 Wiley Periodicals, Inc.