Banner Health and the University of Arizona: Lessons from their partnership

Just over a decade ago, Banner Health and the University of Arizona’s medical colleges came together to form an academic medical partnership.

Banner Health acquired the University of Arizona Health Network in 2015, leading to the creation of Banner-University Medicine. Now, Dr. Benjamin Schwartz, Banner Health’s president of academic delivery, and Patricia Prelock, the University of Arizona’s provost and chief academic officer, are sharing their insights about the success of the merger and working together in a time of change.

In an interview with Chief Healthcare Executive®, they demonstrated one key element in the partnership: they clearly have great respect for each other. They see each other every week and they talked with ease and gentle humor. But they also stressed the need to be candid with concerns to solve problems.

During the conversation, they shed light on meeting the goals of delivering healthcare, training doctors, and supporting cutting-edge research. They also outlined their goal of including care throughout Arizona and across the Southwest.

“I think the leaders at the time saw the real value that one plus one is three, in the sense that if you could bring the strength of Banner's care delivery model with the strength of the university and our tripartite mission in academic medicine, it was an enormous catalyst,” Schwartz says.

The importance of alignment

Last year, Prelock took a step that Schwartz says was “really wonderful” in examining the key strategic documents of both Banner Health and the university.

As it turns out, there was a great deal of synergy, as Prelock explains.

“This is a health system. They have to meet a financial bottom line and care for patients. And this is a medical school, and they have a requirement to train the best and do research. But when we put it together and we identified what are our shared interests, they are almost exactly the same,” Prelock says.

Schwartz concurs, saying that there was “about 95% overlap” in the strategies of the health system and the university.

“The subtle differences that exist in our cultures are far overshadowed by how aligned we are in the things that we do,” he says.

Prelock also says there is strong alignment in financial priorities.

“You have to have financial alignment, and you have to have investment in things that we know we need to do to be on the cutting edge and stay on the cutting edge,” Prelock says.

The leaders say Banner Health CEO Amy Perry and Suresh Garimella, the president of the University of Arizona, are very aligned culturally, which helps immensely. They also credited the support of Arizona’s lawmakers and the university’s board.

While the heads of the two institutions expect results, Prelock says that she and Schwartz are empowered to work together and get things done.

They also pointed to the brand strength of both the university and Banner and the effort to build support for a shared vision.

“It creates confidence for the patients, it creates confidence for the students, the faculty, the physicians, donors who want to come and invest,” Prelock says. “And I think it signaled to people that we would compete nationally in an academic medicine framework, and that physicians would practice in a system that was committed to quality and innovation, and have the research to back up and translate that innovation from bench science to clinical practice.”

“I think ultimately our goal is the care for patients. How we get there might be a little different, but if we keep our eye on the ball … the number one goal of our alignment is the health of our patients,” she adds.

‘Us, not us and them’

Banner Health and the university also benefit from a strong shared governance model, the leaders say.

Schwartz and Prelock co-chair a committee that develops a consensus on important decisions around healthcare delivery, education and research.

“A huge part of our success has been in all of our meetings, it is we, it is us, not us and them, and so I think that's an extremely, extremely powerful component to our success,” Schwartz says.

He also cites the value of being accountable to each other and the visibility both institutions have in meeting goals.

“Both organizations are really, really well designed to have accountability of each other, so that model works well when you have really great transparency,” Schwartz says. “But you also have things to measure and to watch and to hold each other accountable for, and I think you know one of the wonderful things about our relationship is that neither side is perfect, and we're willing to accept those imperfections.”

Schwartz says that the leaders in both institutions have developed a degree of candor with each other, including the recognition of where one is stronger than the other in a certain area.

“There are things about how the university does things that are really wonderful. There are things that Banner does that are really wonderful. And then there are things that on both sides are opportunities. And so I think where our relationship has really thrived is we can say, you know what, it would be really better if you did that, and it would be really better if we did that,” Schwartz says.

‘We don’t doubt motives’

Both leaders also talk about the importance of trust between Banner Health and the University of Arizona, as well as each other.

Prelock says she appreciates the ability to talk honestly with Schwartz.

“Ben and I might not always agree on everything, but we can bring issues, we can talk about it,” she says. “We can get rid of some of the significant issues that people have, and just say, OK. How are we going to make this work? How is this going to be best for our students? How's this going to be best for the community?

“And it's really empowered us to have this relationship that we can go back and forth, and we can also get rid of some of the nonsense that occurs when people have their own agendas,” she says.

Schwartz says that Prelock has helped instill trust, which is critical to the collaboration.

“The healthiest relationships are built on trust, and I give Patty tremendous credit. Her approach to leadership makes all of us at Banner feel that we can trust her,” Schwartz says.

“And so when we don't agree, we don't doubt motives,” he continues. “Because we trust the university leadership so much, it forces us to reflect on why don't we agree, and why are we not seeing it through the same lens that they do.”

Schwartz says that level of trust ensures the relationship between Banner Health and the university is not transactional.

“It's a special sauce in our success, for sure,” he says.

Prelock echoed the need to recognize good intentions in areas of disagreement.

“He and I might get passionate about things, but we can do that in a safe place,” she says.

She says that willingness to wrestle with tough decisions helps also galvanize support from other leaders in the university and the health system.

“When they come to us, they know that we've already spoken, and that we have talked through these things, and that we care about their interests,” Prelock says. “Sometimes we may make a decision that isn't exactly what they wanted, but Ben and I have to look at the bigger picture and what is going to be best for both institutions, and I think this trust piece is really important.”