Phoenix-based Banner Health entered a long-term collaboration with Hartford, Conn.-based Aetna in 2016 to create a provider-partnered health plan. Health plans were first offered to members in 2017.
Now more than five years after the initial announcement, results of the Banner|Aetna collaboration “show improvement in all areas of the value equation,” according to the AHA.
Three highlights from the AHA analysis:
- Payer operations at Banner Health have grown to serve more than 310,000 Medicare and Medicaid enrollees.
- Cost reductions of over $900 monthly per member after the creation of a special fund for payment barriers.
- The development of multidisciplinary care teams for patient conditions like diabetes, asthma or heart disease has led to improved patient interactions with their healthcare plans.
Based on these results, the AHA also highlighted the following four takeaways:
- Both Aetna and Banner Health agreed to push outpatient care management and utilization-management services to the health system, and now Banner nurses and physicians make about half of utilization-management decisions, such as prior authorization.
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The partnership better defines each company’s respective boundaries of healthcare services.
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Health systems supporting payers does not lead to genuine collaboration in the same way that a joint venture between a payer and provider does.
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The joint venture has more access to resources and innovations thanks to pooled expertise from Banner, Aetna and CVS Health, Aetna’s parent company.
At the Becker's 5th Annual Fall Payer Issues Roundtable, taking place November 2–3 in Chicago, payer executives and healthcare leaders will come together to discuss value-based care, regulatory changes, cost management strategies and innovations shaping the future of payer-provider collaboration. Apply for complimentary registration now.