Health insurance ‘payvider’ models are driving innovation in the marketplace — here’s how employers can benefit - Phoenix Business Journal

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Tom Grote, CEO of Arizona-based joint venture Banner|Aetna, explains how the innovative “payvider” model works and how local organizations are already seeing the benefits.

“Payvider” can refer to a wide range of models that take the concept of accountable care – which encourages health care organizations to work together to share accountability for quality and costs – and design it around the needs of the community to make it more sustainable. Joint venture health plans such as Banner|Aetna are the most evolved form of this collaboration.

Banner|Aetna is an example of this model in action. Since launching five years ago, it has become the fastest growing health plan in Arizona. It also offers coverage for both employers and individuals directly since the company joined the Affordable Care Act health care exchange last year.Banner|Aetna is the only joint venture carrier in Arizona.

Since this is a model that focuses on making care more affordable for employers, public entities and members, there are many aspects of joint ventures that focus on lowering these costs. In our case, because Banner Health is accountable for profits and losses, this organization has skin in the game and wants to help members access appropriate and affordable care.

 

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