1 00:00:02,240 --> 00:00:05,059 This is where health insurance leadership comes together. 2 00:00:05,279 --> 00:00:08,960 Becker's fourth annual spring payer issues roundtable brings 3 00:00:08,960 --> 00:00:12,259 together over 400 payer and health plan executives 4 00:00:12,400 --> 00:00:16,524 and more than 100 speakers to Chicago April. 5 00:00:16,904 --> 00:00:19,785 This year's event includes keynote conversations with the 6 00:00:19,785 --> 00:00:23,064 industry's top leaders and former president George W. 7 00:00:23,064 --> 00:00:25,704 Bush. For the full agenda and event details, 8 00:00:25,704 --> 00:00:27,785 visit beckershospitalreview.com 9 00:00:27,785 --> 00:00:29,224 and click on the events tab in the 10 00:00:29,224 --> 00:00:31,519 upper right. We're looking forward to hosting you 11 00:00:31,519 --> 00:00:32,659 here in Chicago. 12 00:00:34,000 --> 00:00:35,920 Hello, everyone, and welcome to Becker's Health Care 13 00:00:35,920 --> 00:00:38,320 Podcast. I'm Scott King. Thrilled today to be 14 00:00:38,320 --> 00:00:41,359 joined by Brett Bingham, chief network development officer, 15 00:00:41,359 --> 00:00:43,280 Banner Plans and Networks. Brett, how are you 16 00:00:43,280 --> 00:00:45,140 doing today? Thanks so much for joining us. 17 00:00:45,484 --> 00:00:47,184 Thanks for having me. It's a great day. 18 00:00:47,725 --> 00:00:49,244 Certainly is. In some parts of the world, 19 00:00:49,244 --> 00:00:52,144 we were talking weather earlier. Chicago's suffering. But 20 00:00:52,445 --> 00:00:53,884 despite all that, we, you know, we have 21 00:00:53,884 --> 00:00:55,424 a lot of big topics 22 00:00:55,964 --> 00:00:58,304 and news to get to, with health plans 23 00:00:58,750 --> 00:01:00,030 and with health care in general. But before 24 00:01:00,030 --> 00:01:00,990 we do that, I was wondering if you 25 00:01:00,990 --> 00:01:02,590 could please just tell us a little bit 26 00:01:02,590 --> 00:01:04,609 about your background and your career journey. 27 00:01:05,310 --> 00:01:07,549 Sure. I'd be happy to. So I've been 28 00:01:07,549 --> 00:01:09,390 with Banner for about five years now, and 29 00:01:09,390 --> 00:01:11,170 I get to lead our provider networks. 30 00:01:12,015 --> 00:01:14,255 Really enjoy the role with Banner. As an 31 00:01:14,255 --> 00:01:17,055 integrated delivery system that's not for profit, it's 32 00:01:17,055 --> 00:01:19,615 very focused on connecting the right pieces of 33 00:01:19,615 --> 00:01:20,355 health care, 34 00:01:20,655 --> 00:01:22,335 and it's fun to align with such a 35 00:01:22,335 --> 00:01:23,075 great organization. 36 00:01:23,890 --> 00:01:25,569 Before this, I got to spend some time 37 00:01:25,569 --> 00:01:26,630 with a rural, 38 00:01:27,490 --> 00:01:28,230 sole provider 39 00:01:29,010 --> 00:01:31,569 health system down in Yuma, so about 420 40 00:01:31,569 --> 00:01:33,650 beds there on Vida Health. And then did 41 00:01:33,650 --> 00:01:36,549 some work with UNC Health, a small APACO, 42 00:01:37,875 --> 00:01:40,114 the Durham kind of VA Medical Center and 43 00:01:40,114 --> 00:01:42,194 some other things before that. So it's it's 44 00:01:42,194 --> 00:01:43,174 been a fun ride. 45 00:01:44,034 --> 00:01:46,454 Appreciate sharing that background info. Definitely interesting, 46 00:01:46,834 --> 00:01:48,834 career you've had so far and a great 47 00:01:48,834 --> 00:01:50,054 perspective on things. 48 00:01:50,435 --> 00:01:52,534 How are your relationships with providers 49 00:01:53,219 --> 00:01:53,719 changing 50 00:01:54,180 --> 00:01:57,620 as both sides face cost pressures and workforce 51 00:01:57,620 --> 00:01:58,120 shortages? 52 00:01:59,060 --> 00:02:01,219 You know, this is really interesting. I think 53 00:02:01,219 --> 00:02:03,240 in the industry, we're seeing a lot, 54 00:02:03,700 --> 00:02:05,159 in the media of potential 55 00:02:05,540 --> 00:02:06,040 adversarial 56 00:02:06,555 --> 00:02:08,955 situations and that's something to be very cautious 57 00:02:08,955 --> 00:02:09,455 of. 58 00:02:09,915 --> 00:02:10,655 Our relationships 59 00:02:11,034 --> 00:02:13,594 with providers are really more moving more into 60 00:02:13,594 --> 00:02:16,735 a shared interests and aligned incentives aspect. 61 00:02:17,034 --> 00:02:18,875 We think that trust is something that's really 62 00:02:18,875 --> 00:02:20,875 important right now as we're all facing these 63 00:02:20,875 --> 00:02:21,375 pressures 64 00:02:21,800 --> 00:02:24,439 and building that trust with providers is certainly 65 00:02:24,439 --> 00:02:24,939 critical. 66 00:02:25,560 --> 00:02:27,240 One of the challenges that we're kind of 67 00:02:27,240 --> 00:02:28,060 seeing is 68 00:02:28,439 --> 00:02:31,240 the dynamic of shifting away from more fee 69 00:02:31,240 --> 00:02:32,460 for service rate fights 70 00:02:32,919 --> 00:02:33,580 to more, 71 00:02:34,354 --> 00:02:36,615 focus around solving access staffing, 72 00:02:37,155 --> 00:02:39,314 and other aspects that are a big challenge 73 00:02:39,314 --> 00:02:39,974 for providers. 74 00:02:41,074 --> 00:02:42,675 So, Brett, do you think kind of, like, 75 00:02:42,675 --> 00:02:45,155 across the board, certainly now with, you know, 76 00:02:45,155 --> 00:02:46,134 a lot of the regulatory 77 00:02:46,719 --> 00:02:48,400 pressures and and some you just touched on, 78 00:02:48,400 --> 00:02:50,560 are both sides just kind of maybe a 79 00:02:50,560 --> 00:02:52,319 little more so coming to the table and 80 00:02:52,319 --> 00:02:54,560 willing to collaborate because they both know, look, 81 00:02:54,560 --> 00:02:56,719 you're up against x y z. I'm up 82 00:02:56,719 --> 00:02:58,239 against x y z. Let's try to get 83 00:02:58,239 --> 00:02:59,060 something done. 84 00:02:59,935 --> 00:03:02,415 Yeah. I I think you're exactly right. Many 85 00:03:02,415 --> 00:03:05,135 providers and payers are coming together in more 86 00:03:05,135 --> 00:03:08,194 creative and innovative ways, and I applaud that. 87 00:03:08,495 --> 00:03:10,594 We're also seeing some providers 88 00:03:11,694 --> 00:03:13,935 or payers taking a different approach, which is 89 00:03:13,935 --> 00:03:15,155 a bit tougher because 90 00:03:15,669 --> 00:03:17,830 those that are focused on the collaboration are 91 00:03:17,830 --> 00:03:19,110 those that are really gonna win in the 92 00:03:19,110 --> 00:03:19,849 long run. 93 00:03:21,030 --> 00:03:21,530 Absolutely. 94 00:03:22,069 --> 00:03:23,590 Brett, where do you see the biggest gap 95 00:03:23,590 --> 00:03:26,729 today between payer strategy and operational execution? 96 00:03:27,954 --> 00:03:29,555 You know, this is a really good question. 97 00:03:29,555 --> 00:03:32,294 I think that strategy is very much so 98 00:03:32,354 --> 00:03:34,935 outpacing the infrastructure across the industry. 99 00:03:36,114 --> 00:03:39,074 Some organizations that are more vertically integrated are 100 00:03:39,074 --> 00:03:40,614 definitely farther along. 101 00:03:41,060 --> 00:03:42,739 But I think one of the pieces here 102 00:03:42,739 --> 00:03:44,819 is everybody has some kind of value based 103 00:03:44,819 --> 00:03:45,639 care strategy, 104 00:03:45,939 --> 00:03:48,439 but very few have the data, the contract 105 00:03:48,500 --> 00:03:50,819 terms, or the operation set up in a 106 00:03:50,819 --> 00:03:52,919 way that they can actually achieve things. 107 00:03:54,194 --> 00:03:56,594 What's one investment or initiative you believe will 108 00:03:56,594 --> 00:03:58,615 most reshape how health plans operate? 109 00:03:59,474 --> 00:04:01,895 I mean, everybody's hitting AI pretty hard. 110 00:04:02,194 --> 00:04:02,775 I think 111 00:04:03,074 --> 00:04:05,314 health plans that really invest on a different 112 00:04:05,314 --> 00:04:06,215 payment methodology 113 00:04:06,514 --> 00:04:08,055 are those that are going to win. 114 00:04:08,840 --> 00:04:11,159 The biggest challenge is that with value based 115 00:04:11,159 --> 00:04:13,639 care and actually incentivizing for the outcomes that 116 00:04:13,639 --> 00:04:14,379 we need, 117 00:04:14,840 --> 00:04:17,500 the data latency is just so long. Reports 118 00:04:17,560 --> 00:04:19,560 and and shared savings can be two years 119 00:04:19,560 --> 00:04:20,060 away. 120 00:04:20,805 --> 00:04:24,404 Getting leading indicator payments on annual wellness visits, 121 00:04:24,404 --> 00:04:28,024 care gap closures, fully addressing and and 122 00:04:28,404 --> 00:04:30,725 not just clicking the button, but actually treating 123 00:04:30,725 --> 00:04:32,504 patients for the conditions they have. 124 00:04:33,279 --> 00:04:34,019 Yeah. Absolutely. 125 00:04:34,479 --> 00:04:35,919 If you let me ask you. If you 126 00:04:35,919 --> 00:04:37,139 could change one 127 00:04:37,519 --> 00:04:40,800 regulatory or industry practice tomorrow, so, you know, 128 00:04:40,800 --> 00:04:41,620 very soon, 129 00:04:42,000 --> 00:04:43,779 to improve affordability and access, 130 00:04:44,160 --> 00:04:45,540 what would it be and why? 131 00:04:46,334 --> 00:04:48,435 That's that's a really good question. I think 132 00:04:48,574 --> 00:04:50,894 there's a lot of struggle around checking the 133 00:04:50,894 --> 00:04:51,394 box, 134 00:04:52,095 --> 00:04:53,694 with some of the different pieces that are 135 00:04:53,694 --> 00:04:54,355 out there. 136 00:04:54,735 --> 00:04:56,654 As we think about how we engage the 137 00:04:56,654 --> 00:04:58,975 consumer more, I think that is a missing 138 00:04:58,975 --> 00:04:59,475 piece. 139 00:05:00,240 --> 00:05:02,480 We know that incentives and and things like 140 00:05:02,480 --> 00:05:03,779 that to the actual, 141 00:05:04,560 --> 00:05:05,779 patient or member, 142 00:05:06,480 --> 00:05:08,639 there's a real delicate line to be walked 143 00:05:08,639 --> 00:05:09,620 there. But, ultimately, 144 00:05:10,080 --> 00:05:12,800 if we can engage individuals more meaningfully in 145 00:05:12,800 --> 00:05:15,595 their health, I think that they'd find better 146 00:05:15,595 --> 00:05:16,095 outcomes. 147 00:05:17,274 --> 00:05:19,295 And, Brett, do you do that by embracing, 148 00:05:19,595 --> 00:05:20,955 you know, a lot of the things that 149 00:05:20,955 --> 00:05:22,014 emerging tech 150 00:05:22,555 --> 00:05:24,795 have given to to health plans? Because they 151 00:05:24,875 --> 00:05:26,819 like like you said, they the consumers expect 152 00:05:26,819 --> 00:05:28,500 things easier. They expect to be met. Do 153 00:05:28,500 --> 00:05:30,199 do you do that through emerging tech? 154 00:05:31,139 --> 00:05:33,300 Yes. I think that there's there's all sorts 155 00:05:33,300 --> 00:05:36,120 of different pieces around that. Banner has invested 156 00:05:36,180 --> 00:05:38,339 very heavily in how we're working with our 157 00:05:38,339 --> 00:05:38,839 consumers, 158 00:05:39,384 --> 00:05:42,185 especially in the realms of patient experience, member 159 00:05:42,185 --> 00:05:42,685 experience, 160 00:05:43,064 --> 00:05:45,305 and just making health care easier so life 161 00:05:45,305 --> 00:05:47,384 can be better. The big challenge with all 162 00:05:47,384 --> 00:05:50,584 this is moving large organizations forward can take 163 00:05:50,584 --> 00:05:52,985 time and effort, but Banner's certainly been very 164 00:05:52,985 --> 00:05:54,125 committed to that cause. 165 00:05:55,069 --> 00:05:58,769 That's great to hear. What issue is putting 166 00:05:58,990 --> 00:06:01,069 the most pressure on health plan margins right 167 00:06:01,069 --> 00:06:01,569 now, 168 00:06:02,029 --> 00:06:02,529 and 169 00:06:02,990 --> 00:06:05,229 how will you respond differently, this year in 170 00:06:05,229 --> 00:06:06,189 in 2026 171 00:06:06,189 --> 00:06:06,849 to that? 172 00:06:07,550 --> 00:06:09,310 You know, that's that's a really good question. 173 00:06:09,310 --> 00:06:09,970 I think 174 00:06:10,805 --> 00:06:13,785 we've seen a lot of increases in expenses 175 00:06:13,845 --> 00:06:16,324 across the board. And so I think there's 176 00:06:16,324 --> 00:06:18,725 just multiple pieces coming together at the same 177 00:06:18,725 --> 00:06:19,225 time. 178 00:06:19,685 --> 00:06:22,324 And organizations that can really focus on their 179 00:06:22,324 --> 00:06:22,824 agility 180 00:06:23,209 --> 00:06:25,449 and rely on the time that it just 181 00:06:25,449 --> 00:06:28,170 kind of living out their investments that they've 182 00:06:28,170 --> 00:06:30,089 made and making sure they have the time 183 00:06:30,089 --> 00:06:31,610 to kind of see those through is really 184 00:06:31,610 --> 00:06:32,110 important. 185 00:06:32,569 --> 00:06:34,730 I think we've seen a number of players 186 00:06:34,730 --> 00:06:37,389 in the industry shift strategies too quickly. 187 00:06:37,805 --> 00:06:39,964 They'll be partway through an endeavor and then 188 00:06:39,964 --> 00:06:42,225 then they maybe shift before they finish it. 189 00:06:42,444 --> 00:06:44,444 Banner has been really true to its course, 190 00:06:44,444 --> 00:06:45,904 and that's been, you know, 191 00:06:46,205 --> 00:06:48,045 a great thing because it allows us to 192 00:06:48,045 --> 00:06:49,964 remain committed on the pieces that we're well 193 00:06:49,964 --> 00:06:50,759 grounded in 194 00:06:51,240 --> 00:06:52,379 without floundering 195 00:06:52,680 --> 00:06:54,699 when we see a hiccup of of challenge. 196 00:06:55,800 --> 00:06:57,800 What are some investments, Brett, that you think 197 00:06:57,800 --> 00:07:00,439 either either banner or all payers just have 198 00:07:00,439 --> 00:07:02,279 to kinda be a little patient with in 199 00:07:02,279 --> 00:07:04,439 terms of seeing them through and and seeing 200 00:07:04,439 --> 00:07:05,580 them pay off? 201 00:07:06,375 --> 00:07:08,314 Yeah. That's that's another good question. 202 00:07:08,854 --> 00:07:11,175 A big piece on that one is more 203 00:07:11,175 --> 00:07:13,914 deeply integrating care delivery capabilities. 204 00:07:14,774 --> 00:07:17,014 So as we think about the historical payer 205 00:07:17,014 --> 00:07:17,514 landscape, 206 00:07:17,894 --> 00:07:19,034 it's very contractually 207 00:07:19,334 --> 00:07:19,834 based. 208 00:07:20,189 --> 00:07:22,830 I think the organization that focus on focuses 209 00:07:23,069 --> 00:07:25,569 I think the organizations that focus more on, 210 00:07:26,430 --> 00:07:28,670 the actual integration of pieces and getting the 211 00:07:28,670 --> 00:07:29,730 data to connect 212 00:07:30,110 --> 00:07:32,050 at point of care and then 213 00:07:32,589 --> 00:07:33,810 allowing for flexibilities, 214 00:07:34,845 --> 00:07:36,865 for different payers to kind of work with 215 00:07:37,165 --> 00:07:39,504 advanced models, c I n, ACOs, 216 00:07:39,884 --> 00:07:40,384 MSOs, 217 00:07:41,004 --> 00:07:44,285 and just other type of engagement vehicles with 218 00:07:44,285 --> 00:07:45,904 primary care is really important. 219 00:07:47,270 --> 00:07:48,150 And the last thing I want to ask 220 00:07:48,150 --> 00:07:49,910 you, Brett, you know, I I think leadership 221 00:07:49,910 --> 00:07:51,990 is so important now in health care, you 222 00:07:51,990 --> 00:07:54,230 know, probably more than ever before with everything 223 00:07:54,230 --> 00:07:55,770 going on. Just wanted to ask, 224 00:07:56,150 --> 00:07:57,529 how you evolved as a leader? 225 00:07:58,069 --> 00:08:00,444 Yeah. That's that's another good thought. I think 226 00:08:00,444 --> 00:08:03,025 the biggest thing is transparency and collaboration. 227 00:08:03,725 --> 00:08:05,324 It's a big industry, but at the same 228 00:08:05,324 --> 00:08:07,345 time, it's really small. And 229 00:08:07,884 --> 00:08:09,985 if if you burn your relationships, 230 00:08:10,764 --> 00:08:12,625 for some kind of a quick win, 231 00:08:13,310 --> 00:08:16,110 those those never recover. And so as we 232 00:08:16,110 --> 00:08:18,589 think about working with with teams, no matter 233 00:08:18,589 --> 00:08:20,449 how big or small they are, 234 00:08:21,149 --> 00:08:23,790 just being transparent and straightforward with the challenges 235 00:08:23,790 --> 00:08:24,769 that we all face, 236 00:08:25,069 --> 00:08:27,104 and then being willing to kind of hear 237 00:08:27,104 --> 00:08:29,044 the voices of lots of different individuals 238 00:08:29,425 --> 00:08:31,524 to navigate through things in the right way. 239 00:08:31,824 --> 00:08:33,424 We're all doing the best that we can. 240 00:08:33,424 --> 00:08:36,544 It's a challenging time. But as we continue 241 00:08:36,544 --> 00:08:38,384 to kind of work together and focus on 242 00:08:38,384 --> 00:08:41,105 our greatest asset, our people, then we're gonna 243 00:08:41,105 --> 00:08:42,404 be able to get through it. 244 00:08:43,100 --> 00:08:44,379 Brett, thanks so much for joining us on 245 00:08:44,379 --> 00:08:46,220 the podcast. It was a great conversation and 246 00:08:46,220 --> 00:08:47,580 really looking forward to having you speak at 247 00:08:47,580 --> 00:08:49,980 the Spring Payer Issues roundtable. Hey. Thank you. 248 00:08:49,980 --> 00:08:51,440 I've definitely enjoyed it.