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. Why would risks for providers be higher for a center of excellence? . If you ran an ACO, would you choose a center of excellence or reference pricing? Have centers of excellence grown as expected? Have high-performance networks? - Would you be willing to go to a center of excellence if you needed spine surgery? - Would you be willing to go to Cancun if you needed a hip replacement? Zurich? - What are the alternatives to a center of excellence program