When Banner Health and Aetna formed Banner|Aetna in January, the goal was to better the member experience and improve health outcomes and engagement with providers while reducing the cost of health care in Arizona.
The collaboration combines Banner Health’s fully integrated care teams and care-management capabilities with Aetna’s health plan expertise and analytical insights. Banner|Aetna is one of five Aetna joint ventures, including Innovation Health in Virginia, Texas Health Aetna in Dallas-Fort Worth, Allina HealthIAetna in Minneapolis, and Sutter HealthIAetna in northern California.
“We’re disrupting the status quo by embracing a new model of care delivery that provides reliable high-quality and cost-efficient care to members.”
The collaboration builds upon the success of Aetna and Banner Health’s five-year accountable care organization (ACO) relationship. Banner Health and Aetna’s ACO resulted in a 24 percent reduction in avoidable surgical admissions, an 11.5 percent reduction in medical costs versus expected costs for the area and $9.9 million in shared savings.
Banner|Aetna held a Health Care Summit for 175 brokers in Scottsdale, Arizona, to provide updates and dig into detail about how it is working to improve member experience and health outcomes.
“We are connecting our systems to deliver an easier health care experience for our members. From plan selection, member onboarding, searching for in-network providers and booking appointments, to reviewing claims and lab results, we are making the health care process easier for our members,” said Grote. “We’re disrupting the status quo by embracing a new model of care delivery that provides reliable high-quality and cost-efficient care to members.”
Grote and others explained at the summit how Banner|Aetna is using a neighborhood care approach with multidisciplinary care teams of clinicians including a chief medical officer, case managers, pharmacists, nutritionists and social workers, to help care for members. The care teams educate and support members and their families in convenient locations when and where they need it.
“We need to move from not just treating health care at the exam table, but also where people live,” Grote said. “Whether it’s at the kitchen table or interfacing with them with digital tools and helping them maximize their health opportunities.”
Banner|Aetna’s multidisciplinary team approach is already seeing success among its members. A 41-year-old woman had a number of medical issues, including obesity, and was the primary caregiver of her grandmother, who has dementia. Banner|Aetna brought in a support team made up of a heart doctor and case manager to help her navigate the health care system, a nutritionist to develop a meal plan, and a social worker to help her enroll in programs to get paid to take care of her grandmother.
“We need to move from not just treating health care at the exam table, but also where people live.”
Banner|Aetna members also have access to an online portal, which they can use to schedule appointments and communicate with some providers. Members with, or at risk of, a chronic condition can also be identified and helped with prevention and advanced services, as well as on-going condition management though Banner|Aetna’s multidisciplinary team.
Banner|Aetna members also have greater access to additional places to obtain health services, including retail clinics and Banner-owned urgent care centers, which work within the neighborhood care approach to ensure coordination with the member’s doctors.
Banner|Aetna’s member care model is different than the traditional fee-for-service system, where doctors are paid based on the type of medical service they provide to patients. In a value-based care setting, doctors are rewarded for better patient outcomes.
“Transitioning away from a fee-for-service model has allowed Banner|Aetna to be nimbler, creating a better experience for its members,” Grote said. “Our new model of health care delivery in Arizona has the potential to become a national model for how an insurance company and a provider can create a sustainable solution for population health care management, while setting a standard of excellence for the patient experience.”