More employers are implementing value-based reimbursement and payment arrangements with insurers and providers, according to a survey released by employee benefits consulting firm Willis Towers Watson.

Some 600 employers with more than 1,000 workers responded. In 2016, 45 percent of those companies said they’re giving workers access to Centers of Excellence (COEs), organizations which have higher quality ratings in specialties like cardiology and joint treatment. That’s up from 37 percent in 2015, and more may soon join them, as an additional 32 percent of surveyed employers said they plan to implement COEs by 2018.

“As employers grapple with how to lower the cost of health care without lowering quality, they are increasingly looking to pay medical service providers for health outcomes instead of the services they provide,” Trevis Parson, the firm’s chief actuary for health and benefits, said in a statement. “Today, these strategies are more common in geographies where employers have large concentrations of employees or where cost-efficient providers are available and willing to engage in emerging reimbursement models.”

Parson said it’s the beginning of the larger transition away from fee-for-service care as more employers emphasize these value-based strategies in health plans. Twenty percent of employers surveyed said they’ve implemented high-performance networks (up from 11 percent in 2015) and 16 percent said they’re considering contracting directly with service providers in the future.

All signs in the survey point to more employers being swept up in this trend in the near future. For example, by 2018, 47 percent of employers said they would reduce point-of-care costs for the use of high-value services, and 31 percent said they require employees to pay more for certain procedures if they don’t get a second opinion.

For insurers and providers, new opportunities exist if they can offer plan designs that match these new goals.

“The greatest challenges are not only getting employees to use value-based services but also to find health care plans and providers that can deliver them,” said Sarah Oliver, a Willis Towers Watson senior consultant.