Health and well-being has long been a stand-alone category within which organizations have created narrowly defined programs.
But there is a growing awareness of the interconnectedness of lifestyle and healthcare choices, and the organizations featured in this article share what they are doing to build on that.
In this regard, many discuss their efforts with Blue Zones. The term refers to pockets of populations globally that naturally enjoy extraordinary health and longevity, and studies have resulted in efforts to purposely create similar environments in other communities. Organizations also address additional societal factors that impact healthcare.
Blue Cross Blue Shield of Arizona
Pam Kehaly, CEO
We know that if we can positively impact overall health in our state, Arizonans will enjoy a better quality of life and be able to keep their healthcare costs down. To inspire health, we are addressing some of our state’s biggest health challenges. Over the past two years, Blue Cross Blue Shield of Arizona (AZ Blue) has launched two statewide action plans (one for diabetes and the other for behavioral health), enhanced its community efforts through the Blue Cross Blue Shield of Arizona Foundation for Community & Health Advancement, and is moving its strategy toward health solutions.
AZ Blue has teamed up with Arizona Department of Health Services to raise diabetes awareness and turn that awareness into action. Together, we’ve set an ambitious, but attainable, goal of reducing the progression of diabetes by 25% by 2025. The vast plan includes five major objectives including: reducing A1c levels, increasing engagement of members living with diabetes, and increasing provider coordination and accessibility, to name a few.
We’ve also set a goal of engaging 525,000 Arizonans in improving behavioral health by 2025. We want to see a decrease in deaths by despair, overdose, anxiety, depression, and other behavioral health conditions. We are also aiming for an increase in certain measures, such as the number of people who know the 988 Suicide & Crisis Lifeline by heart and the number of Arizonans trained in Mental Health First Aid. These action plans are meant to be a launching pad for conversation, connection to resources, and change throughout the state.
The Blue Cross Blue Shield of Arizona Foundation for Community & Health Advancement also works toward uplifting Arizona’s communities through four focus areas including: chronic health conditions, mental health, health equity, and substance use disorder. The Foundation’s impact is amplified through cross-sector partnerships with trusted local organizations. Through its funding opportunities, the Foundation is expanding boots-on-the-ground efforts and investing in programs and applied research that improve well-being and address health disparities. In 2022, the Foundation funded nearly $3 million through 88 grants to 85 Arizona organizations, including a $2 million investment in mental health alone. By the end of Q3 this year, the Foundation will have provided nearly $2 million in funding through 37 grants.
AZ Blue has expanded its strategy beyond health insurance and is moving toward health solutions. This allows the company to play a larger role in improving healthcare for Arizonans. As a start to this endeavor, we launched a new subsidiary, Prosano Health Solutions Inc.
Blue Cross Blue Shield of Arizona is proud to be an integral part of Arizona’s communities. This year, we have taken bold steps to become a health solutions company. Not only do we build products and services to meet the state’s needs, but we partner with community organizations and collaborate with the Arizona healthcare community to create solutions to make it easier for Arizonans to manage their healthcare.
Earlier this year, Prosano Health Solutions Inc., a new company, launched its first Advanced Primary Care Center, with three more Maricopa County locations opening in 2024. The Advanced Primary Care Centers offer a comprehensive care model that includes one-stop access to a primary care team, behavioral health practitioners, lab services, same-day appointments, virtual options, and a selection of the most needed prescription medications. Through Prosano Health, our focus will shift beyond Advanced Primary Care to an entire ecosystem of solutions that meet our commitment to delivering a better consumer experience.
Strengthening Business and the Economy
As a company, Blue Cross Blue Shield of Arizona has made a commitment to stand up for affordability, because we know that is one of the top healthcare concerns for not only employers, but all Arizonans. Our members have made it clear: They are looking for affordable health coverage and care. We aim to ensure that our members, and all Arizonans, get the most amount of health for every dollar spent on care. Every individual deserves quality, high-value, accessible care.
This year, AZ Blue launched a Clinical Rapid Response team to help members navigate the healthcare system and also clear barriers to affordable care. The team assists members who are experiencing a health scare or are being assessed, recently diagnosed or in treatment for a clinical condition. We aim to make it easy by accelerating necessary approvals for procedures, treatments and medications and expediting appointments with in-network providers.
Employers are also aware that mental health is a top health concern among their employees. A study done by AZ Blue shows that there is room to improve the level of awareness of mental health benefits, and 60% of those surveyed experienced a barrier in accessing mental health resources. Physical health is just as important as mental health and, as a company, we can help provide education, resources and support to our employer groups that can improve mental health outcomes.
Blue Cross Blue Shield of Arizona recognizes that the well-being of employees is key to the well-being of an organization. Employers have the responsibility to ensure the health of their employees is a top priority, and we are here to help provide employers with tools and resources to do so.
We created a team of certified instructors and built the infrastructure to deliver Mental Health First Aid Training to employer groups. We advise employers to highlight the value of mental well-being by encouraging their employees to get MHFA training on company time and paid for by their employer. We advocate for leaders to model the importance of mental well-being through MHFA and by modeling positive behavior in their everyday actions. Our goal is to help address the need for behavioral health resources — to help reduce stigma, increase mental health literacy, understand mental health concerns and provide evidence-based offerings that are accessible to our communities.
Each of our employer groups has access to a dedicated health promotion executive who helps the employer strategize and develop their wellness offerings. Ultimately, this impacts the employer’s bottom line, and results in improved employee retention and morale. We also offer monthly no-cost wellness webinars available to all employees of our employer groups.
Cigna
Brad Anderson, VP of Sales in Arizona
Whether it’s through our longstanding accountable care arrangements, in which we collaborate with providers on improved health outcomes for our customers, or more tailored innovations to best suit the needs of an employer’s workforce, Cigna Healthcare is always looking for ways to make the health care system work better.
Given the pandemic, one thing we continue to hear from our clients is a growing need for mental health services for their workforces. That is why we are taking a more coordinated approach to whole-person health with a specialized focus on behavioral health. There are a few things we are doing to make mental health services more accessible for clients and their workforces.
One of these programs is MDLIVE. Starting in January 2022, the Cigna Health Plan significantly expanded access to covered virtual care services for millions of customers enrolled in employer-sponsored plans. Through MDLIVE, we offer things like urgent care, primary care and dermatology services — but we also offer virtual behavioral health services. This is a big deal for customers because it expands their access to therapists tremendously — not to mention offers more convenience.
We are also broadening our Employee Assistance Program offerings. For instance, we are seeing higher demand for onsite EAP, which resulted in a 47.7% increase in the number of onsite EAP counselors over last year. Onsite EAP use has become much more popular because it allows employers to offer a set number of hours their employees can have with a therapist onsite. It also makes it easier for employees because they can make an appointment without worrying about finding their own therapist. Additionally, all of our EAP providers are in our behavioral health network, so there is a seamless transition if a customer has an EAP therapist they want to keep seeing outside the EAP offerings.
Something that is currently underway is our partnership with the Blue Zones Project. This is an exciting new initiative that helps us carry forward our goal of improving the systems, structures and processes that contribute to our health here locally. The Blue Zones Project is laser focused on the supporting factors that contribute to our health — things like good schools, parks, transportation options, walkable communities, etc. We know that if we have those necessities as part of our daily lives — and we are continually improving upon them — we are going to stand a much better chance of being healthy and successful in our endeavors.
In the health care industry, we have come to learn that 80 percent of our health outcomes are determined by things that happen outside the doctor’s office. That’s why it’s so vitally important that we are partnering with communities, local governments and businesses to give our neighbors, friends and colleagues the best chance at health as possible. The Blue Zones Project will help us get there.
Strengthening Business and the Economy
Cigna Healthcare offers Your New Growth Plan as a way to advance employee health and business growth. There’s a proven link between the health of employees and the health of a company — especially in times of uncertainty. Cigna Healthcare helps employees achieve their best health, which, in turn, helps employers position themselves for growth by driving employee productivity and more consistent performance.
The four pillars of Your New Growth Plan are:
- Engaging Employees: Improve productivity and health outcomes by guiding them to the most effective, convenient and cost-appropriate care when they need it.
- Nurturing a Healthy Work Culture: Establish and maintain healthy work practices that reduce stress and burnout among employee populations.
- Ensuring Financial Health: Help employees better manage and control their health-related finances.
- Preparing for the Future: Stay informed on the latest advancements in healthcare and continuously innovate to address the health challenges of today and tomorrow.
We are very fortunate to have a long history in the Arizona market, buoyed by Evernorth Care Group’s 50-plus-year existence (formerly Cigna Medical Group) and deep community partnerships, including the Blue Zones Project that will further elevate our quality of life in Arizona. From a Cigna Healthcare perspective, we have offerings for individuals in various stages of their life, including those who get their benefits from their employer, seniors who have our Medicare Advantage plans, and individuals who get their care on exchanges through our Individual and Family Plans.
Delta Dental of Arizona
Michael Jones, President and CEO; Chair of Delta Dental of Arizona Foundation
Delta Dental of Arizona, which serves over 1.4 million enrollees and more than 3,700 contracted dentists across the state, is creating a path to better health and wellness. Since 1972, we’ve worked to provide affordable coverage to a wide variety of employers, groups, and individuals in each of our 15 counties — urban and rural communities alike — as well as advocate for preventive care and the direct connection between oral health and overall health. We do this through our extensive network as well as through our Foundation, which since 2010 has given more than $16 million to support oral health education and disease prevention programs for underserved and uninsured communities.
Medical-Dental Integration (MDI) will continue to be a high priority for Delta Dental of Arizona.
By way of example, in July 2023 we partnered with the Banner Health Foundation to announce the expansion of the Hospital Oral Care and Periodontal Disease Education (HOPE) program protocol to Banner’s 28 acute-care hospitals across Arizona, California, Colorado, Nebraska, Nevada, and Wyoming. After successfully piloting the program for nearly a year, this expansion will enable all Banner medical centers to implement the oral health protocol, potentially serving up to 300,000 patients each year. This collaboration offers a window into our future and the types of initiatives Delta Dental of Arizona will pursue.
In addition to our Banner partnership, Delta Dental of Arizona supports several organizations across the state to advance MDI, a few of which are:
- Flagstaff Medical Center Children’s Health Center, which provides support to patients with chronic and disabling conditions that can inhibit their ability to use a regular toothbrush.
- Mountain Park Health Center’s Preventive Dental Care for Pregnant Patients, which provides no-cost preventive dental exams, x-rays, cleanings and education to pregnant women as part of their prenatal care.
- North Country Healthcare’s Medical-Dental Integration Program, which embeds basic oral health screenings, fluoride varnish applications and dental education into existing pediatric and obstetric appointments to assist in reinforcing the medical-dental connection.
- United Community Health Center’s Dental Care for Kids, which integrates oral health services and education to over 800 low-income, underserved children during their medical well visits at United Community Health Center’s pediatric care.
In addition to MDI and equity and inclusion, Delta Dental of Arizona invests heavily in overall public awareness related to oral health and preventative care through volunteerism, thought leadership, and innovative educational solutions. For example, in August 2023 we partnered with Arizona PBS Kids to launch HealthySmileLearning.org, a FREE resource site in both English and Spanish for parents, caregivers, children, and teachers featuring family friendly videos, resources and classroom curriculum focused on oral health.
Strengthening Business and the Economy
Health benefits are a valuable tool for attracting top talent, yet employers continue to grapple with rising benefit costs that outpace the rate of inflation. This remains one of the biggest challenges to profitability and can divert resources away from other desired investments by making employers extra cautious. Additionally, tension on both the domestic and global stage is causing anxiety, destabilization and general uncertainty, which employees bring to work. Therefore, access to behavioral healthcare has become a growing priority for employers.
As we often say great care isn’t worth much if you can’t afford to use it. That’s why Delta Dental of Arizona is committed to offering dependable value in the form of solutions that meet the unique needs and budgets of employers of all sizes. Coupled with the strength of our network that extends into our rural communities, employers can trust us to provide their employees with access to the convenient and industry-leading care they need.
Another way we empower employers is through our helpful, caring and responsive customer service, which is a direct byproduct of our people-first culture. There is a deep organizational commitment at Delta Dental of Arizona to provide employers and employees with the respect and guidance they deserve. Evidence of this? In August 2023, for the ninth consecutive year, Delta Dental of Arizona earned the Center of Excellence certification by BenchmarkPortal. The Center of Excellence recognition is one of the most prestigious awards in the customer service and support industry, which demonstrates our dedication to providing superior customer care.
Additionally, we are making significant investments in science, data and technology to improve the health and wellness experiences of our members. We look forward to making future announcements that will illuminate these efforts.
Referring again to MDI, Delta Dental of Arizona is also focused on equity and inclusion.
We know that racial and ethnic diversity among health professionals is linked to improved outcomes and greater health equity. Yet, the current oral health workforce hasn’t kept pace with the changing demographics of the U.S. population. We are an organization committed to reducing the challenges associated with restricted access and poor health outcomes, and facilitating a more diverse workforce is a great mechanism for accomplishing this objective.
To that end, in March 2023 we were excited to announce a partnership with the Delta Dental Institute to launch Driving Greater Diversity in the Oral Health Workforce, a campaign to help increase the number of oral health professionals from historically underrepresented groups. The campaign aims to advance a more diverse oral health workforce via the Delta Dental Oral Health Diversity Fund, which will make targeted investments of up to $1 million toward comprehensive solutions, innovative pilots and scalable models that inspire school-aged children from historically underrepresented groups to pursue a career in oral health. Additionally, it will support initiatives in oral health education, research and community investment.
In many ways our growth story mirrors the trajectory of the state we have supported for more than 50 years. The Arizona economy continues to expand in size and sophistication in ways few of us could have imagined a generation ago, from the growth of manufacturing jobs across our state to the level of international investment which led the entire nation in 2022. Delta Dental of Arizona is investing in the future to support that growth, by adding new jobs, increasing contributions to organizations in need via our Foundation, and providing paid time off to our employees to volunteer in the community. Additionally, we see an opportunity to take what we already do well in dental and vision and apply it to more areas of health and wellness, which inspired us to refresh our mission statement in 2023. This will be an area of significant focus for us in the months and years to come.
Equality Health
Lisa Stevens Anderson, Regional Market President
Equality Health is a mission-driven company. At our core, we are committed to advancing health equity by breaking down barriers to care and helping individuals live a healthier life no matter their background or socioeconomic status. In VBC, providers, their patients, and our communities all reap the benefits of better outcomes.
Because Equality Health also extends the reach of primary care practices into the places where the most clinically complex members live and work, we can be effective at helping patients access services to address Social Determinants of Health. Through Equality Health Foundation, we also get involved in local communities to deliver resources and education in partnership with community-based organizations at the state and local municipality level. Our annual Healthy Fall Festivals are a strong example of our community impact, and we are coming up on these events locally in November.
Equality Health is here helping independent primary care providers (PCPs) shift the focus of the healthcare delivery system from volume to value. We do this by providing PCPs with the technology and support they need to continue delivering high-quality care for underserved communities, which often comprise some of the most complex patients.
The shift to Value-Based Care is quite challenging to make for any healthcare organization blue a health system, a hospital, or a clinic group — but especially for independent practices, who may have just a few providers and small office teams. PCPs in Arizona — and across the U.S. — need access to technologies that help automate labor-intensive back-office functions (for example, around value-based care contracts with health plans), identify and close care gaps in care for their patients, and flag high-risk patients or patients who may struggle with Social Determinants of Health. These social barriers are often in play for the most complex patients. That is why we launched Equality Health at Home, a new service where field-based community health workers and nurse practitioners can support the care provided by the PCP.
Given that Arizona spent $17.6 billion in FY2021 on the Medicaid program, according to reporting from KFF, we all need to help make those dollars work smarter and more efficiently. Across Arizona, Equality Health works with over 2,200 primary care providers and 6,500 total providers, serving more than 325,000 members across the state.
The results we have achieved through our continued focus on provider enablement is highlighted through aligned provider partnerships, such as Happy Kids/Feliz Care, and at the individual patient level such as Becky’s story.
One of the biggest healthcare concerns for Arizona right now is that we have too few PCPs. According to this AZ primary care workforce report, from the University of Arizona’s Center for Rural Health, we rank 42nd in the nation for primary care services — with roughly 80 primary care physicians for 100,000 people, compared to the U.S. median of about 94. In the Valley, one in five residents are unsure how they will get care, and in rural areas that stat is two in every five.
Strengthening Business and the Economy
Equality Health is headquartered in Phoenix. We employ 300-plus associates, the majority of whom are based here in the Phoenix metro. We are growing, continuing to expand our network and our value-based care model deeper into Arizona communities and across the nation. We started here in Arizona and are now supporting PCPs in Texas, Tennessee and Louisiana, with plans to open up new state markets next year. Because we focus on partnering with and supporting independent primary care practices — which are small businesses — we look forward to continuing to help these businesses thrive and stay independent as the shift to value-based care continues.
The dearth of primary care physicians means that too many people go without care or they wait until there is a bigger healthcare crisis, which may result in an ED visit or hospital stay — a more expensive path, driving up healthcare costs and running counter to VBC goals. Primary care providers are crucial to combating this — and it’s through the great work of so many of our local providers to focus on a culturally competent, whole-person approach that we can counter this trend.
The good news is that there are many state leaders and initiatives in play working to improve primary care access including training, support and recruiting of PCPs. The Resident Physician Shortage Reduction Act of 2023, a bipartisan bill introduced in the U.S. Congress in March of this year, aims to help this national issue. This federal legislation would pave the way for Arizona-based hospitals and medical centers to receive federal reimbursement funding, expanding the number of residency positions they could offer, with the hope to bring more medical students to Arizona and the strong likelihood they stay after graduation. ASU also announced in June that it is launching a new medical school aimed at the healthcare challenges we face in the state.
With our focus on PCPs and supporting them in communities across the state, we are pleased to be part of the solution to this statewide challenge.
HonorHealth
Todd LaPorte, CEO
HonorHealth is proud to be on the leading edge of transforming healthcare in Maricopa County by leveraging advanced technologies and evidence-based practices to address the toughest challenges. That means not just providing the highest quality care for patients in need, but empowering healthy choices that can positively impact the well-being of individuals every day.
We are responsibly expanding our offerings according to the needs of our community, with more access points for convenience and affordability. We are enhancing and adding programs that widen the comprehensive scope of conditions that need treatment and healing. Our footprint of primary care and urgent care clinics throughout the Valley are already among the most extensive for a healthcare system like ours. Examples of recent expansion include the $170M expansion at our Deer Valley Medical Center, a new $60M Cardiovascular Center of Excellence at our Scottsdale Shea Medical Center, a 95,000 square foot medical campus in Peoria that will serve multiple needs for patients in the West Valley, and a 100,000 square foot sports medicine and wellness campus in Scottsdale that will more tightly connect traditional medicine and whole-body wellness.
We continue to expand our footprint of specialty care practices and outpatient surgery centers to provide more convenient access and affordability for cases that can safely be done outside a full-service hospital.
HonorHealth was the first in Arizona to offer a freestanding urgent care and emergency department hybrid concept that provides an array of services, but only bills for the level of care a patient needs. That means less cost if only urgent care is required, despite a facility that can provide emergency level service if necessary.
We are also focusing on how to promote well-being and truly honoring health – as our name declares – in addition to our capabilities for addressing acute care needs. That means we want to help people manage their health before, during and after a hospitalization. Focusing on that “before” component is what compelled us to be the presenting sponsor for Blue Zones Project Scottsdale, an exciting initiative that will transform the environments where people live, work, learn and play to improve community well-being, resilience, and economic vitality.
The project is based on research and principles developed by studying cultures of the world — or Blue Zones — with the healthiest, longest-living populations. It seeks to improve the overall well-being of our community’s residents. Well-being includes social, financial, mental and community health. By focusing on making permanent and semi-permanent changes to the Life Radius, the area close to home where people spend 90% of their lives, Blue Zones has helped communities achieve measurable improvements in its residents’ health including double-digit drops in chronic disease rates, better health equity for all and measurable savings in healthcare costs. While this initiative will start in Scottsdale, we are confident the Blue Zones message, and desire to make healthy lifestyle choices, will spread throughout the Valley and even beyond.
Strengthening Business and the Economy
The HonorHealth story dates back to 1927 when the John C. Lincoln family came to Phoenix and began a legacy of caring for neighbors beyond just healthcare services — services such as a food bank, early childhood education and adult day healthcare. Our story includes the legacy of Scottsdale Healthcare and its unique work as a research institute, and our partnership with the U.S. military to train critical care nurses. HonorHealth is more than your typical nonprofit, community hospital system. We continually strive to go beyond and put honor above all.
We actively collaborate with our staff of employed and independent physicians through our clinically integrated network, Innovation Care Partners, to proactively identify and assist patients at high risk for chronic health conditions. We help those patients navigate the healthcare ecosystem to manage their chronic diseases more effectively. This approach provides value to each patient and to our community as a whole.
I believe the future is bright for what HonorHealth can do for the communities we serve, but it only happens if we take care of our most valuable asset: our team of caregivers and support professionals. HonorHealth is the largest employer in Scottsdale and the ninth largest employer in the State of Arizona with nearly 14,000 team members and more than 3,700 physicians. But to meet the growing need for high-quality healthcare in developing parts of the Valley, we must continue to grow our team, while taking care of our current team members. We do that by nurturing a healthy and diverse workforce, with a culture centered around caring for each other like we do for our patients. We have a variety of programs that support their whole health: physical, emotional and financial well-being. We are confident this approach will allow us to fulfill our mission to improve the health and well-being of those we serve.
Mercy Care
Tad Gary, Deputy CEO
Mercy Care uses data from a variety of sources to identify opportunities to improve the health of our community. This data can help identify health disparities, needs for different delivery mechanisms or ways to direct resources, and more.
For example, to improve mental health and wellbeing of youth in foster care, we formed a joint workgroup with the Department of Child Safety Comprehensive Health Plan (DCS CHP) on young adult substance use mitigation and suicide prevention. This workgroup is addressing rising incidences of youth who are in foster care experiencing opioid overdose and suicide ideation.
Mercy Care and DCS CHP leadership analyzed the data for trends, sent out a survey to congregate care settings to assess needs around substance use and suicide, and are currently meeting bi-monthly to develop and implement a joint strategic plan that includes intervention and prevention tactics to improve health outcomes (e.g., reduce fatal and non-fatal overdoses and suicide attempts).
Workgroup outcomes include the development and provision of a two-phase education and training series for providers and caregivers focusing on substance use and suicide prevention awareness and skills training. We partnered with Sonoran Prevention Works to provide NARCAN kits and training, and with Community Bridges to provide a presentation on Current Drug Trends. There have also been trainings on fentanyl awareness and prevention, and we will be training providers and caregivers on suicide alertness skills in the coming months.
We also provide funding and resources to help educate the community about health disparities and the importance of eliminating them. For example, in April 2023 we hosted a screening and panel discussion for the film “Birthing Justice,” which puts a spotlight on the systemic racism and related issues that contribute to the unnecessarily high rate of maternal mortality in the United States.
Strengthening Business and the Economy
Mercy Care has invested funding and other resources to help direct care providers find ways to build and develop their workforce. We incentivize providers to use effective processes to develop their workforces. They receive incentives by implementing plans to develop a talent pool, recruit, hire, train, and retain staff. From summer 2018 to December 2022, we ran a pilot program that added 4,000 new DCWs to the work force.
Further, as a not-for-profit Arizona health plan, we re-invest millions of dollars back into the community, helping local non-profits create healthier communities by bringing new staff on board. For example, community reinvestment funding has helped to fund case management positions for a local agency that provides permanent supportive housing and related services to people in need.
A 2021 survey from the Paraprofessional Healthcare Institute concluded that Arizona will need more than 190,000 new direct care workers by 2030, to meet the needs of the aging population. Direct care workers, or DCWs, work in healthcare facilities and private homes. They help people who require personal assistance and long-term care services, such as bathing, dressing and medication management. They make it possible for patients to choose where and how they live. Most people prefer to age at home and not in a nursing home or similar facility, and direct care workers provide the support patients need to do that.
We’re also providing programming and resources to people who are providing live-in care to their family members, to help close the gap created by not having enough direct care workers. This includes help for people living with dementia and their care partners. It also includes training and education for workforce professionals to understand dementia and address complicated behaviors without relying on unnecessary medication or institutionalization.
Mercy Care honors the sovereignty, strength and resilience of all 22 tribal nations in Arizona. In 2021, we expanded our Tribal Relations Department to enhance tribal member healthcare system navigation and access to whole-person health supports. With their unique understanding of the Indigenous health perspective and community resources, our tribal liaisons help design holistic systems and resources to meet the healthcare needs and assist tribal nations with social risk factors that may impact their well-being. We provide traditional healing supplemental benefits for tribal members who choose traditional healers to meet their spiritual needs and bridge systemic gaps in cultural care.
Further, we are staunch advocates for the LGBTQIA+ community. We were the first AHCCCS health plan to remove prior-authorization requirements for PrEP therapy and Rapid Start Treatment protocols for people at risk of exposure to, or diagnosed with, HIV. PrEP is very effective at preventing HIV transmission, and Rapid Start Treatment means starting Antiretroviral Therapy as early as the same day of a person’s diagnosis.
Phoenix Children’s
Rich Lehmuth, SVP of Strategic Planning and Chief Strategy Officer
As Maricopa County continues to grow at record-breaking speed, so does our population of children and families — and so do the demands for healthcare. Phoenix Children’s is answering the call by building new locations, recruiting top leaders, growing our workforce and expanding our services to ensure Arizona families have access to high-quality care — much closer to home.
In the last year, Phoenix Children’s Medical Group has launched several new programs and divisions and hired expert pediatric subspecialists to lead them. We created a new Division of Anesthesiology in December 2022, led by Dr. Narasimhan “Sim” Jagannathan, division chief and Dr. Amod Sawardekar, associate division chief. In total, 39 other pediatric providers transferred from a longstanding private anesthesiology practice into Phoenix Children’s Medical Group.
Also in December, we created the Phoenix Children’s Center for Cleft and Craniofacial Care and added nine subspecialists in plastic surgery, craniofacial orthodontia, clinical genetics, and speech language pathology. Leading this group are Dr. Davinder J. Singh, division chief of plastic surgery, and co-directors Patricia Beals, DMD, craniofacial orthodontist; and Kelly Cordero, PhD, CCC-SLP, a speech-language pathologist.
And, in September 2022, we launched a new Division of Infectious Diseases, led by Dr. Wassim Ballan. Dr. Ballan, who joined Phoenix Children’s in 2007, became a national thought leader during the pandemic, providing invaluable guidance to Phoenix Children’s and the families we serve on topics including COVID-19, MIS-C and vaccine safety and efficacy.
We’re also focused on strengthening our research program to advance new treatments for devastating childhood conditions. In May, we launched The Phoenix Children’s Research Institute at the University of Arizona College of Medicine – Phoenix, which formalized our longtime research collaboration with UA. Directing the Institute is Vlad Kalinichenko, MD, PhD, who joined Phoenix Children’s in March 2023. He is a globally renowned scientist whose hire represents a major leap forward for our research program. Before coming to Phoenix, Dr. Kalinichenko led a team of researchers at his namesake laboratory, the Kalinichenko Research Lab, at Cincinnati Children’s. Six members of his team also transitioned to Phoenix Children’s.
In addition, we continue to prioritize the care of Arizona’s most vulnerable children. This work includes our Homeless Youth Outreach program, which was founded 22 years ago, and a fleet of Crews’n Healthmobile mobile medical units that travel across the Phoenix metro to serve impoverished and homeless youth. These “doctor’s offices on wheels” visit shelters, group homes, drop-in centers and schools throughout the Valley. The Homeless Youth Outreach program also includes four fixed-site clinics at UMOM New Day Center, Phoenix Dream Center, Children First Leadership Academy and Youth Development Institute, offering more than 30 half-day clinics each week and completing up to 12,000 visits a year.
Phoenix Children’s Bridge Clinic, which launched in 2018, expedites the stabilization and treatment of high-risk children who come to the Phoenix Children’s emergency department, often for self-harm or suicidal ideation. Patients meet with a Phoenix Children’s behavioral health provider as often as necessary — sometimes daily — as a “bridge” while long-term care with a community pediatric provider is arranged. The outcomes have been overwhelmingly positive. Among them, there’s a marked decrease in the number of former Bridge Clinic patients returning to the ER, an indicator they’re receiving high-quality care in the community.
We’re also working with community pediatricians to reach more children experiencing behavioral and mental health issues. These doctors have advocated for increased mental health services for their patients, which prompted the launch of a new initiative at Phoenix Children’s — the Psychiatry Faculty Learning Community — to remove barriers and connect kids with the care they need.
In addition to our investments in physical expansion, we are also a critical pipeline for training the next generation of medical talent, and this goes beyond our large residency and fellowship programs. Medical, nursing and social work students must complete a rotation in pediatrics as part of their education — whether or not they intend to work with children after they graduate. Phoenix Children’s is the only option for these rotations, which means we’re training thousands of students each year.
Strengthening Business and the Economy
Employees consistently rank healthcare as the most important benefit at work. As a result, employers are looking for health plans that provide access to affordable, high-quality care and meet the needs and expectations of their workforce. For employees who have children, coverage of pediatric health services is a top concern.
This is one of the reasons Phoenix Children’s is working so diligently to build out our network of care. Our expansion strategy centers on bringing top-ranked pediatric healthcare closer to home for families across the Valley — to ensure they can access the services they need within their own communities.
At the same time, we’re focused on providing affordable care. Data from the Children’s Hospital Association shows Phoenix Children’s inpatient reimbursement rates are between 24% and 34% lower on average than children’s hospitals nationally — all while we provide a full continuum of care to children.
A top-ranked children’s hospital attracts businesses to the Valley and makes Arizona a more desirable place to work and live. This is key for companies considering a move here or prospective employees who may be looking to relocate their families to Arizona.
We’re also empowering businesses and their employees through our support of families whose children need ongoing care for chronic conditions. We work closely with parents to manage their kids’ complex care, so taking care of a child doesn’t have to be a parent’s full-time job. Instead, they can spend more quality time with their families and bring their best selves to work, which contributes to a healthy and vibrant workforce.
It’s also widely reported that most American workers prioritize healthcare benefits above nearly everything else — including a pay raise. A healthcare package that includes Phoenix Children’s and Phoenix Children’s Medical Group gives employers a competitive edge in attracting and retaining key staff.
Not only do we offer comprehensive care for infants, children and teens, but we’re the only Level 1 Pediatric Trauma Center in the state and the only children’s hospital in Arizona ever to be recognized as a “Best Children’s Hospital” by U.S. News & World Report. We’ve been named a “Best Children’s Hospital” for 13 years running.
Currently, we are in the middle of a $400-million expansion that will add major new sites across the Valley, increase the depth and breadth of services we provide, improve access to care for Arizona families, create new jobs across the Valley and infuse dollars in local economies. Once all sites are open, Phoenix Children’s will be one of the nation’s largest pediatric health systems.
UnitedHealthcare
Heather Kane, CEO for Arizona and New Mexico
At UnitedHealthcare and across UnitedHealth Group, we touch virtually every aspect of the health care system.Importantly, we are committed to expanding access to quality care, in part by building and sustaining trusted relationships with medical providers. Over the last eight years, our network of health care providers in Arizona has increased by 40%, and we currently contract with 91 hospitals and more than 39,600 health care providers across the state to help encourage our members to access the right care, at the right time and in the right setting. During that same timeframe, UnitedHealth Group, which includes UnitedHealthcare and Optum, has grown our Arizona-based workforce by nearly 28% to more than 8,000 employees supporting the health care needs of more than 1.8 million members statewide.
We are making health coverage more affordable by taking costs out of the system, including with modernized clinical programs, innovative plan designs, network configurations, and other practices to incentivize high-quality, evidence-based care that improves health and lowers medical costs.
One way we are doing that is by removing financial barriers to care, including offering plans that provide members first-dollar coverage. For instance, we recently started eliminating out-of-pocket costs for 24/7 Virtual Visits for eligible members enrolled in applicable fully insured employer-sponsored plans, offering plan participants an option to access care professionals anytime to help treat a range of medical issues. Eliminating out-of-pocket expenses for 24/7 Virtual Visits can help improve health equity by reducing the burden of medical costs for consumers and encouraging earlier interventions, which can reduce the risk of complications and avoid visits to costlier settings such as the emergency room.
We are using technology and an approach focused on consumer needs to help make it easier and more convenient for our members to access care, while collaborating with physicians to reduce administrative requirements and improve the flow of information so doctors can focus on delivering the best possible care.
For our members, we are developing advocacy solutions that make it easier to navigate the health system, especially to help better support members with complex or special health needs such as autism, Down syndrome, and genetic disorders. As an example, our Special Needs Initiative uses analytics to help identify families with children who have special health care needs and then assigns a designated advisor who provides information and support to help members make more informed decisions. This advisor can support all members of the family (not just the child), take responsibility for each inquiry that surfaces along a care path, and help drive improved coordination with the child’s care team.
And we are committed to value-based care, which places a greater focus on quality health outcomes, supported by data sharing between the health plan and care provider, leading to improved value for all participants in the health system. For employers in Arizona, this VBC model of care is at the heart of two of our most innovative plans — NexusACO plan and Doctors Plan of Arizona — which are patient-centered collaborations among providers that promote coordinated care and lower costs to patients.
Strengthening Business and the Economy
When I talk with employers in Arizona, their priorities generally match the concerns of employers nationwide: maintaining or improving coverage while increasing affordability. To help achieve that, it is vital for employers to implement innovative programs that encourage access to quality, evidence-based care while working to reduce the 25% of annual health care spending that may be wasteful. By doing so, employers can help attract and retain top talent and enable strategic cost management.
We are increasingly seeing employers focused on helping employees make more informed healthcare decisions. According to UnitedHealthcare research, employees made less-than-optimal health care choices 38% of the time, which directly impacted their health — and increased the cost of healthcare for everyone. And with more than half of all adults having one or more chronic conditions, clinical management strategies play a key role in containing costs.
For instance, UnitedHealthcare leverages advanced analytics to identify employees who might have chronic and high-cost conditions that would benefit from outreach. A nurse asks if the employee would like to participate in proactive engagement through digital tools that include secure text messaging, online live chats or nurse outreach based on digital device readings.
More broadly, here are some of the most common questions our team receives from employers:
- How can we simplify the health care system and make it easier to navigate?
- How can we leverage data and technology to create a more engaging experience?
- How can we offer innovative plan designs that help people access the right care, at the right time and in the right setting?
Our Arizona team is prepared to address each of these concerns and provide solutions that employers can afford and employees and their dependents will appreciate. The right package of benefits, clinical programs and consumer engagement strategies will vary by employer, so we focus on collaborating with organizations to build customized and comprehensive solutions.
For our 800,000 members enrolled in employer-sponsored plans across Arizona, we are focused on creating a more coordinated, connected, and personalized health system. To that end, our UnitedHealth Group enterprise annually invests more than $5 billion in data, technology, innovation and research, helping make it easier for people to maximize the value of their benefits. A few examples are:
- Enhanced advocacy models: The goal of advocacy is to offer personalized support to help improve member health and satisfaction, close gaps in care and reduce costs. Through our enhanced Advocate4Me customer care model, an analysis of large and mid-size employers found these resources reduced the total medical cost of care by up to 4% per year while improving enrollment in relevant clinical programs.
- Modern wellness programs: While most employers offer well-being programs, only 23% of employees use these wellness initiatives. To make these initiatives more engaging, we are rolling out UnitedHealthcare Rewards, a program in which eligible members, including spouses, can use wearable devices to earn up to $1,000 each per year by completing various daily health goals and one-time activities. Due to its design and daily opportunities to earn incentives, registered UHC Rewards members are over twice as engaged with their health plan via our digital resources compared to non-registered members.
- Plans with upfront pricing: More employers are opting for health plans that do away with deductibles and instead give employees first-dollar coverage, coupled with access to upfront pricing information before they schedule medical appointments. One example is UnitedHealthcare’s Surest™, which uses value-based copays and provides cost and coverage information for common medical services in advance of treatment. A recent study found Surest members experience 6% fewer ER visits, 13% fewer inpatient hospital admissions and a seven-fold increase in virtual care use, helping reduce healthcare expenses for members and employers.
Across Arizona, UnitedHealthcare is invested in the well-being of our people and our state. That includes an annual financial investment exceeding $790 million, spanning total wages, taxes paid and contractor spending. We are focused on community investment as well, with giving across our enterprise and the United Health Foundation surpassing $4.6 million in Arizona last year alone. In addition, our Arizona-based UnitedHealth Group employees contributed $1.7 million in donations and company matching funds, as well as an estimated 110,000 volunteer hours to important community causes and local nonprofits.
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