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Ensuring excellence in centers of excellence programs. Studies have found associations between better outcomes and a variety of structural and process criteria that help explain the wide outcome variations that occur across hospitals. In response, Centers of Excellence programs have been developed by multiple third parties. Despite this, programs have yielded disappointing results and can have unintended consequences. To outweigh potential harms, outcomes at Centers of Excellence must be clearly superior. We need to change how hospitals are designated and provide evidence that Centers of Excellence are truly excellent.