Banner Health exec: Providers must seize ‘accountable care’ opportunity

LOVELAND – Ballooning costs and antiquated ways of doing business have plagued U.S. health care, but large health-care providers have an opportunity change the situation, a Banner Health executive said Wednesday.

“Health care for a very large number of us doesn’t work very well, actually,” said Dr. John Hensing, Phoenix-based Banner Health’s chief medical officer and executive vice president. But as the industry changes, he said, “We can take advantage of that evolution.”

The Banner Health executive made the remarks during a presentation at the Fort Collins Area Chamber of Commerce’s Health Care Summit 2015 at Embassy Suites in Loveland. Hensing, who started his career as a U.S. Air Force flight surgeon, has spent four decades in health care. Banner Health operates North Colorado Medical Center in Greeley and McKee Medical Center in Loveland. The health-care provider also plans to open a new 22-bed hospital in Fort Collins on Monday.

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Hensing spoke of the “role of the patient” to take greater responsibility for his or her health as hospitals shift from relying on fees they charge patients to running their organizations through contracts with other health-care providers and focusing on preventative care.

Banner Health has sought to manage care of certain populations, particularly by addressing the needs of chronically ill patients, who account for the bulk of health care spending.

The provider has made progress by using mobile nurse and physician teams and technology that aids remote communication. In one such program where Banner Health delivered care to 600 patients, it saw a 30 percent reduction in costs.

Hensing gave an example of patients who take multiple prescription drugs at certain times of day: Medical staff members help administer those drugs to prevent the patient from missing a dose and ending up in the emergency room, where care costs more.

“We’ve had some early success in our ability to manage health,” he said. “We want to be much more proactive.”

Providers have financial incentives to perform what he called “accountable care.” They can enter into contracts with other health-care providers to care for patients in various networks, as well as reach agreements with large companies to care for employees.

“The provider organization has a whole new set of incentives,” Hensing said.

If hospitals fail to make the shift, they face financial losses.

The Obama administration has sought to reduce by $320 billion the amount it spends on Medicare and Medicaid, subsidized health-care programs for the elderly and the poor.

One program fines hospitals for having too many readmissions within a month. Last year, 2,610 hospitals nationwide faced $428 million in fines when 18 percent of Medicare patients who had been hospitalized were readmitted within a month.

Hensing acknowledged that many health care providers have not made the transition.

“One of the reasons it hasn’t worked is we’re still stuck to some degree in early 20th century reimbursement,” he said.