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Becker’s Healthcare Podcast
Inside a Decade of Collaboration Between Banner Health and University of Arizona
00:24:36
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- [00:00]
A
This is Laura Dardo with the Beckers Healthcare Podcast. I'm thrilled today to have Dr. Benjamin Schwartz, President of Academic Delivery at banner Health, and Dr. Patricia Prelock, Provost and Chief Academic Officer at the University of Arizona, on the podcast with me today. Ben. Patti, thank you so much for joining us.
- [00:19]
B
Delighted to be here. Thank you.
- [00:21]
C
Yes, thanks for having us.
- [00:24]
A
Fantastic. Well, I'm excited to have you both here. I know 10 years ago, Banner Health and the University of Arizona really came together with a vision of transforming Healthcare Arizona and have done just that over the last decade. And so I know there's so many things that you've been able to accomplish. Currently more than 1300 residents and fellows train across 80 programs that you've set up and really have had a great investment into the healthcare ecosystem there in Arizona. And so I'm excited to learn more about that and really dive in first and foremost with a 10 year partnership at Banner Health and University of Arizona Academic Medicine merger. Can you tell us what prompted the two organizations to enter this collaboration initially?
- [01:09]
B
Sure. This is Patti. Ben and I talked a little bit about this because we're kind of newbies to this framework. And I think Ben came about 14 months ago. I did about nine months ago. But what we've learned and what we've experienced is that both the University of Arizona and Banner Health were really very strong independent organizations that were really important to the Arizona community. But realizing that as a leading AAU university that really focuses on research and a land grant mission, that we could do better if we worked together and be more powerful as an integrated organization. And then looking at the amazing Banner Health institution where they're a nationally recognized nonprofit integrative health system, how can we use our workforce development and our research to support the incredible work they do to provide the best possible valued care for improving the health of Arizona and the Southwest. And so I think those two institutions became the fabric of Arizona's mission for health and taking care of their population. And it makes the most sense that we do it together and not try and do it separately. As I've come on and I've been with other health systems, it's been a pleasure learning from and working with Ben and his colleagues there and realizing that we have a lot of shared vision. And I know Ben can talk more about this scale and reach that we have that you mentioned a little bit in the beginning. And I think just the I can speak to the research growth. The recruitment of physician scientists, which Banner is so supportive of, has really strengthened our ability to take Research from the bench to the bedside and really make a difference and translate that for best clinical practice. And that's really been achieved through a shared governance and model that we have created on how to work together. But I'm sure Ben can talk a lot about the scale and reach that Banner has and how we've been able to do that together.
- [03:36]
C
Yeah, thanks, Patti. I would just echo every time you and I meet and for the audience we meet at least weekly, I always learn so much from you. And it's really impressive the accomplishment of our affiliation. Ten years ago, you take such a premier academic institution of the University of Arizona and Arizona's largest health system. Together I think we employ close to 100,000 team members. And if you just look at the opportunity our partnership created with regards to the scale of the programs that we have, I think together there's over a thousand medical students learning at any given time. There's over 1100, depending upon how you count 1100 to 1300 residents and fellows in all of the training programs. It's a really, really wonderful place to train. And it's certainly elevated and buoyed the care that's being provided because we have academic providers all across the state. And so when Arizonans seek healthcare, they know when they see our brand, they're coming to a place that's evidence based, that's innovative, state of the art, and know that we're offering them the best chance of the outcome that they're looking for. You know, when we put the block A of the university next to the Banner logo, it's just an incredible, incredibly powerful and resonating image to the communities that we serve, that we're elevating the sophistication of the care that is accessible not just in Arizona's big cities, but also in rural areas, communities.
- [05:18]
B
I'd like to add, Laura, if I could. I think what is so powerful about this relationship is not only Banner Health really supporting our medical students and our residents, but a whole plethora of health professions. Physician assistants, physical therapists, nurses, nurse practitioners, nurse midwifery, and really committed to that which is so powerful. And then giving our students access to research in areas like Alzheimer's and Parkinson's and artificial heart transplants, which is happening at Banner University Medicine. That's a gem for our students at all levels to know that they're coming to a place where there's two high powered institutions who have decided to integrate and work together to create the best possible medical care. Founded in evidence, which is pretty wonderful.
- [06:14]
A
That's Amazing to hear. And you're truly a unique gem, as you mentioned, in terms of the organization. And then the partnerships really makes a big difference. I can imagine learning in that type of environment gives you so many different experiences and really sees how the healthcare system can be beneficial to the communities in these types of collaborations drive value moving forward. Now, what are some of the biggest challenges that you have overcome that really offer useful lessons to pursuing such mergers like this? I think in particular. Particular right now, healthcare is such a team sport. And so looking at how you've been able to be successful and work together well is truly a testament to both organizations and you individually, as well as overall, just what's possible when you do develop those types of relationships.
- [07:02]
B
Yeah. So I think what Ben and I've learned, the best thing for us to do is talk every week, and as things come up, we can address it and get the information that we need. You know, when you're integrating an academic enterprise with a clinical enterprise, it's very complex, and they don't automatically align because we. We have a shared vision. And we actually went through an exercise looking at our vision, mission and value statements, and there was so much in common. But we also know that, you know, Banner has a responsibility to patients and high productivity, and we have a responsibility to research and educating students. And those are not easy things to connect. So I think it really requires us to have joint leadership, like the commitment that Ben and I have made, making sure we're accountable. And sometimes we. We fail on that end, on both ends. And Ben and I talk about it and identify, okay, what could have we done differently and the situation. So we're constantly in an assessment mode of that, and then making sure that culturally our teams can integrate because an institution of higher education is very different than a hospital system. And so recognizing that and knowing that we're making lots of changes with lots of leadership changes that we have to coordinate at scale and. And we've had wonderful support from our Arizona Board of Regents to really help us maintain this infrastructure. They're very committed to the relationship between Banner and the U. Of A. Knowing that it's always going to have its hurdles. But I'm sure Ben has many more things that he could share as well.
- [08:55]
C
Well, I think that was really terrific. A huge part of our culture is centered around trust. And someone once said to me in a meeting, I thought it was really clever that trust is earned a drop at a time and lost in buckets. And I think that's really true. I think it's that regular transparent communication between our organizations, starting with the president of the university and our CEO Amy Perry and President Garamella, Patty and I, the deans and our hospital CEOs and medical group leaders. Transparency is really important and it's something you have to find alignment on every day. I think what has really been wonderful for me in this relationship when it comes to trust and transparency is that these are two organizations that historically have been the very best at what they do. And it comes with a certain amount of pride and it comes with a certain reluctance to admit when the some of the things that you do aren't perfect. And what Patti has been such a wonderful partner with is we call those things out about each other and we help to find ways to. I'll give you a perfect example. One part of the infrastructure of the university may be particularly strong and maybe not a banner and vice versa. And so when we look at our processes of collaboration, we leverage the best practices of each of the organizations where 1 plus 1 is 3 or 120. And so for us that's meant strategically that we can be much more financially sustainable because we're not. We don't have redundant things happening in both organizations whenever we can avoid it. And to Patti's earlier point, even though both organizations have slightly different strategies, I would say the overwhelming majority of those strategies are amazingly aligned. Really great example, the University of Arizona. One of their main focuses is on artificial intelligence and healthcare. And obviously that's an incredibly important strategic part of our journey at Banner. And so there's amazing symbiosis there when we're together and you know, we set a very, very high bar. We want to be not just the best in Arizona, although I think if you look at certain programs, we've done the first in Arizona in many things. Fetal surgery is an example. But we want to be the very, very best in the country, if not in the world. And we have some programs that really give us the opportunity to boast that. And we know that those programs don't happen without both organizations drive to be nationally competitive and to be the very best.
- [11:50]
A
That's amazing to hear. And certainly that candid and transparent communication is so helpful in building what you have been able to build and accomplish that world class care. I think it is so critical to have that type of relationship, but then at the same time be able to look together in the future and see your paths continuing to align together, which is really neat. And I think looking at you mentioned AI too and healthcare care, that's a Huge, huge topic. And something that bringing both institutions together at it seems like it would just accelerate a lot of what you're trying to do.
- [12:25]
C
Absolutely.
- [12:26]
A
Now, what have been some of the biggest benefits of this collaboration? What are your, you know, where do you see some of the opportunities and benefits coming through? What do you think, Patti?
- [12:36]
B
Yeah, well, there's so many impacts. I love that Ben said, well, we want to be nationally competitive, not just the best in Arizona, but the best in the nation. And I think we are in a lot of areas. But I think the big impact areas from an academic and University of Arizona is that we're creating ready to care physicians and health professionals across physician assistants, physical therapists, nurses, midwives, et cetera, which are so critical to meet the care needs of both urban areas, but also our rural community across the state and nationally. So I think the impact has been significant in terms of the number of students who come here who then get jobs and stay in Arizona and have an incredible learning experience and clinical experience. Because of our relationship with Banner Health, they provide so many of the academic clinical internship programs, the residency programs. So our graduates are well trained and people feel like, wow, these students are ready and able to care for us. And really we're improving the retention of individuals in the state that we're training and investing in. And quite frankly, as someone who, who benefits from the care and Banner, I want to make sure that the students that we train and the future healthcare providers are going to do a good job taking care of me. So I so appreciate this ecosystem that we've created for our workforce. But also at the same time, it is this discovery ecosystem that we've also created that really embeds evidence and academic rigor into care delivery for our patients. And it really helps when we have an academic medical center and a well established health center like Banner to recruit individuals who feel that this is a place that they can really engage with the patients they want, have trainees and do things that maybe other health systems could not do. And I know Ben probably has several examples of some of the significant things that have happened at Banner University Medical Center. So I won't take all of his thunder and let him share some things.
- [15:19]
C
Well, that was great, Patty. I. You know, academic medicine is so special and so vitally important, not just to Arizonans or to Americans, but to the world. The challenges of some of the hardest medical conditions and the innovations that have been used in the past and that we're going to use in the future largely are born in an academic medical environment. And you know, our relationship with the university has really brought some of the world's best minds in medicine and some of the best clinicians because those providers are seeking an environment where they can not just be clinically excellent, but can also do research and be educators. I want to just share with you a few examples of how the clinical care at Banner University of Medicine is amazing as a result of our collaboration. But I also want to be careful to make mention then I only have enough time to mention a few and there's probably a few hundred of them. And so to those of you that I don't mention, please know how special you are. But if I think about, I'm a gynecological cancer doctor and I'm particularly proud of the cancer care that's provided both at our Banner University of Arizona Cancer center and at the Banner MD Anderson Cancer Centers. I think when patients are faced with really upsetting diagnoses, I think they take great comfort in coming to one of our facilities. And we've been recognized nationally for the care that we provide in diseases like leukemia, lymphoma, myeloma. You can imagine in a sunny place like Arizona, we have a lot of skin cancer and the skin cancer care that we provide here is second to none. So we've got some of the world's best surgeons, particularly our colon cancer surgeons and our prostate cancer surgeons and the teams that come with them that want to work in a place where they know they're providing the highest level of care. It's really terrific. And we've done some amazing innovative procedures in our facilities, including artificial heart transplants which are rarely found in hospitals in America. But we are not only a place where the quality is excellent, but one of the highest volume places in the country. If you think about the number of heart transplants we've done, I think our facility in 2024 did the most heart transplants in Arizona. And our survival rates are just well above the national and state averages. We're particularly proud in our hospital at Banner University Medical center in Tucson. We're fetal surgery program. These are very hard to find. Our catchment area is the entire southwest, if not further than that. And the teams have a spectacular expertise in a field of medicine that is particularly complicated with taking care of some of the most complicated situations. And then in Phoenix we have arguably the best world class sports medicine institute in Scottsdale where some of the most famous athletes in the world come to not only recover from when they, when they have afflictions, but also to improve their performance. It's really every time we bring someone there, they're blown away with how sophisticated that facility is. And the team of experts that are there are arguably second to none. And again, those people come to work in our facilities because they're so terrific, but mostly because of the relationship that Banner has with the university and the opportunities that being a part of an academic medical center offer them beyond patient care. And so those programs would not happen without this affiliation.
- [19:16]
B
Yeah, and I would second that. And in fact, our athletic spirit program, Banner University manages our sports here at U of A. And it's such a wonderful opportunity to demonstrate true integration. Sports is big here and our, our athletes are also wonderful student scholars. And then to have this cutting edge sports medicine and access with Banner has been a huge lift and another good reason for students to come to U of A. It's a draw.
- [19:53]
A
Absolutely. I can imagine it really tips the scales in many respects towards their favor. So that's amazing to hear. Before we wrap up, I'm curious, what's your top piece of advice for other health systems looking into similar partnerships?
- [20:07]
B
I think the very first thing, and we actually did an exercise for this is making sure you enter the relationship with a shared purpose and not a short term focus. But we're in it for the long game and it does require work to maintain and build collaboration. And I think one of the best things we've done is we have strategy meetings with Banner and U of A with our leaders, our President Garamell and the CEO of Banner, Amy Perry, and our research leads and Ben and myself. And those have been quite powerful in making sure that we maintain our alignment and that we have a plan for the next 10 years so that we can catapult the success we've already had. I'm sure Ben has some additional ideas and thoughts about what's so important.
- [21:07]
C
Yeah, I mean, I appreciate those comments very much, Patty. What I would add is, you know, these are strategic long range initiatives. I think both organizations, particularly in our meetings that you just described, we take great pride that we have found a way to take these very large organizations and move the needles quickly, you know, despite that. But there is a risk, I think that it's important that everybody understand the why of this relationship. And for those that are considering embarking on a similar relationship, I'm proud that we lean into using the word we much more than you and me. And when you bring two large organizations together, there's a bit of a tendency for people to do that. And I would just say that our alignment at the highest levels of the organizations casts a very big shadow. And when things are escalated to us, the way we resolve the challenges in a collaborative way sends a very clear message to the team. Now, I'm not naive to say that money doesn't matter. And so it's really important in these relationships for the incentives to be aligned financially. We have a wonderful collaboration in that context. So much so that even our foundations now are working together to align strategically on philanthropy, which I think is really, really powerful, because it's not just building trust within the organizations together, but it's also how we project that collaboration to the communities that we serve, including those that are philanthropic for us. And so that's a really, really important part of these relationships. And then I would just say it's that sort of continuous commitment to always. We can always be better. We're always going to push ourselves to be better. We're not going to accept the status quo. The world, in case you didn't notice, is changing rapidly around us. And so as that happens, we have to continually be adjusting and shifting and not get trapped in. Well, that's how we did it 10 years ago, so that's how we're going to do it now. And I think I give Patty tremendous credit for this because the University of Arizona is more, through my lens, on the leading edge than always taking the conservative approach. And Banner's very aligned with that. And I think finding those cultural matches between two organizations is critically important.
- [23:47]
B
I think much credit, but it's a we. But you're right. It's investing in culture and trust and knowing that we're going to hit some challenges, but we're in it for the long game. Yep.
- [24:01]
A
I love it. Patty, Ben, thank you so much for your time today. This has been a fabulous conversation. I've really learned a lot, and it's cool to hear about how you're able to work together so well. And then especially during these challenging times, there's so many changes and uncertainties and quick pivots that need to be made. Being able to rely on each other and really build upon both your strengths and alignment together is critical. So. So I appreciate your time today, and I look forward to continuing the conversation in the future.
- [24:30]
B
Thanks so much, Laura.
- [24:31]
C
Yeah, Laura, thank you so much for having us. I appreciate it.