Alternative Payment Model Initiatives at Banner Health
Banner Network Colorado, a physician network based in Greeley, Colo., has formed an accountable care organization (ACO). Its practices, including Banner Internal Medicine in Greeley and Banner Medical Clinic Drake in Fort Collins, have participated in Medicare’s Comprehensive Primary Care (CPC) initiative, working toward shared savings and population-based fees while improving primary care functions. Practices have applied for Comprehensive Primary Care Plus, an advanced model based on the CPC initiative, and the network has also been accepted into Track 2 of the Medicare Shared Savings Program.
Banner MD Anderson Cancer Center in Gilbert, Ariz., and Banner University Medical Group in Tucson are participating in the Oncology Care Model, in which physician practices improve oncology care coordination such as chemotherapy administration while maintaining or lowering Medicare costs.
Two years ago, Banner hospitals in Arizona’s Maricopa County partnered with kidney care company DaVita to create Phoenix-Tucson Kidney Care, an end-stage renal disease (ESRD) Seamless Care Organization (ESCO). Through the Comprehensive ESRD Care (CEC) Model, ESCOs explore new methods of improving care for Medicare beneficiaries.
Banner Estrella Medical Center in Phoenix and Banner Thunderbird Medical Center in Glendale, Ariz., are participating in the Model 2 of the Bundled Payments for Care Improvement (BPCI) initiative, in which participant spending is compared against a target price for inpatient stays along with post-acute care and services up to 90 days after hospital discharge under MS-DRG 469/470 (major joint replacement or lower-extremity reattachment with and without major complications or comorbidities).
Banner purchased University Medical Center and its health plan in Tucson two years ago. Using the organization’s hospital, employed physicians, and community partners, an ACO structure is forming, with the potential to apply for a Medicare program in the future.
“These CMMI [Center for Medicare and Medicaid Innovation] programs are generating many good ideas that become the foundation for other payment arrangements that BHN enters into with its other payers,” says Kathleen Harris, senior director of government operations for BHN.
Elizabeth Barker is a digital communications professional and freelance writer in Chicago.
Interviewed for this article:
Kathleen Harris, senior director of government operations, BHN.