Why local reinvestment matters for Arizona health care

Arizona's health care system is under pressure from rising costs, federal coverage challenges and increasing demand for care.

The idea: Policymakers should place greater value on health systems that invest in keeping people healthy, expand access to care and strengthen the community holistically.

Here's why: Health care costs already strain families, employers and public programs, and when patients lose coverage or skip care because they cannot afford it, the cost shifts across the system.

• Families may avoid seeking care until medical issues are harder and more expensive to address.
• Hospitals may end up providing more uncompensated care, and public programs face higher costs as untreated conditions become more serious and difficult to treat.

Arizona Health Care Cost Containment System (AHCCCS) changes and contract disputes across Arizona are already disrupting care for families that rely on ongoing relationships with providers, like the nearly 1,000 Arizona children at risk of losing access to major autism therapy providers after AHCCCS plans canceled provider contracts.

• But health care systems often bear the consequences of coverage instability without strong incentives to invest in the preventive and coordinated care that can help patients avoid more serious health problems down the road.

The challenge: Most American hospitals still operate in a fee-for-service model that pays for visits, procedures and treatments after patients get sick, a structure that rewards volume rather than the work to keep people healthier before they need costly care.

The solution: Banner Health says Arizona needs a new approach.

Banner Health is one of the nation's few fully integrated nonprofit health systems: Its nonprofit health system delivers care and insures members, giving it a direct stake in prevention.

• Its structure shifts the incentive from treating illness after it becomes urgent to investing earlier in screenings, primary care, coordinated support and disease management.

When patients stay healthy, Banner Health benefits both clinically and financially — and nonprofit care plays a specific role in that equation.

The strategy: As a nonprofit, the system reinvests earnings into care, workforce development, research, community health programs and infrastructure rather than distributing profits to shareholders.

Banner Health says it invested more than $1.1 billion in community benefits last year. That includes:

• Care for uninsured, underinsured and AHCCCS patients.
• Lifesaving research.
• Medical education for thousands of clinicians.
• Hundreds of community health programs.
• Rural and safety-net facilities.

The proof: Nearly a third of Banner Health's care is now focused on prevention.

• Through Banner–University Family Care, an AHCCCS plan, the system says it has increased colorectal cancer screenings by 114% and blood pressure checks by more than 1,100% year over year.
• Banner also says well-child visits in rural counties rose 34%.

The takeaway: Prevention doesn't remove every strain on the system, but earlier care can give patients a better chance at better outcomes while reducing the need for more expensive interventions later.

Arizona can build a stronger health care system by rewarding prevention, recognizing nonprofit reinvestment and protecting the infrastructure that keeps care close to home.

Learn more about Banner Health.