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Local employers can benefit from innovative health insurance payvider models

By: Thomas Grote

There’s no doubt that the last few years have been difficult for employers. A tight labor market and rising health care costs have pushed business leaders to look for innovative ways to retain and attract top talent, all without breaking the bank on insurance benefits.

Because of their unique business structure, payvider health insurance models can help employers and public entities provide coverage that address key pain points like rising employee expectations and growing insurance costs without compromising quality. Many Arizona businesses are already seeing the advantages of implementing modern benefit offerings through health care solutions like the payvider model.

A unique approach

The only joint venture health plan in Arizona, Banner|Aetna is half owned by the largest delivery system in the state–Banner Health, and one of the nation’s largest health insurers–Aetna, which is owned by CVS Health®. This deep expertise across different health care functions allows Banner|Aetna to leverage the strength of each organization to create a better overall experience for members. Because Aetna supports the operational aspects of the health plan like paying claims, billing and customer service, Banner Health providers can focus their efforts on care quality, access, utilization and overseeing one of the industry’s few provider-led care management programs. This is important because insurers are not experts at caring for and supporting patients, so Banner|Aetna keeps clinical decisions in the hands of care providers, where they belong.

Access and affordability

There are many aspects of the joint venture model that work to make care more affordable for employers, public entities, and members. For example, because Banner Health and Aetna equally share profits and losses, both have a vested interest in connecting members with appropriate, but also affordable care. Banner|Aetna’s performance network takes this a step further by encouraging providers to work together and make medically appropriate data-driven decisions. Through these efforts, performance network plans have driven health care cost savings of up to 14 percent.

Of course, it’s helpful to see the results of these unique payvider models in the real world. The Town of Gilbert, a public entity, came to Banner|Aetna because their claims costs were growing out of control. By working closely with their team to design a plan, Banner|Aetna was able to address their unique needs by implementing customized benefits, which leveraged the unique joint venture structure and performance network. In addition, the Banner|Aetna team helped educate and engage their members about the need to make cost-conscious care decisions and how to utilize the organization’s very first wellness offerings. A new wellness program also introduced a variety of innovative offerings designed to lower costs and improve care. Five years after switching to Banner|Aetna’s affordable health insurance, the town continues to benefit from the collaboration and is managing claims costs while maintaining excellent quality of care and employee satisfaction.

For more information about Banner|Aetna or to learn about today’s payvider models, visit BannerAetna.com.