Hidden Gems: Meet Tom Grote of Banner|Aetna

Today we’d like to introduce you to Tom Grote.

Hi Tom, so excited to have you with us today. What can you tell us about your story?
After graduating from Notre Dame, I moved to Connecticut, which is the health insurance capital of the world.

I started my career with Aetna, and over my 35-year career, I have worked in sales, as a general manager, and as a market president in different areas around the country.

I also worked on setting up Aetna’s first joint venture health plan in Virginia, and because of that experience, I was tapped to help form and lead Banner|Aetna, a joint venture health plan owned by Banner Health and Aetna/CVS.

Alright, so let’s dig a little deeper into the story – has it been an easy path overall, and if not, what were the challenges you’ve had to overcome?
When I was eight years old my father passed away from cardiac arrest, which left my mom to raise six children, including a set of newborn twins, on her own. That experience was life-changing and it encouraged me and my siblings to become independent and resilient.

As an adult, I decided to become active in the local Phoenix American Heart Association chapter to help make a difference after losing my brother and best friend to heart attacks as well.

This year as event chair, colleagues, friends, and family came together to help the Banner|Aetna team raise over $68,000 for the Phoenix chapter of the American Heart Association.

Thanks for sharing that. So, maybe next you can tell us a bit more about your business?
Banner|Aetna is a joint venture health insurance company focusing on bettering member outcomes at a lower cost, all while improving the overall member experience for employers and consumers in Arizona.

The unique collaboration combines Banner Health’s high-quality, local providers and delivery systems with Aetna’s health plan experience, care management, and health information technology.

Joint venture health plans like Banner|Aetna serve as a testing ground for innovation because we can leverage national resources paired with a local market understanding. We are flexible enough to move quickly, but also have these great companies like Banner Health, Aetna, and CVS to help bring innovative programs to market.

Under our joint venture model, we share equally in the results of the health plan so we are truly financially aligned. This allows us to delegate this important function to the care delivery side of the house, Banner Health — in the hands of the clinicians who understand patient health and care issues.

We’ve found that by keeping these programs closer to care delivery, we’re able to better connect members with the right local resources, refer the right providers and give them guidance based on the latest research, which is always evolving. This approach is extremely rare in the industry today, but I think it’s where we’re headed. Health insurers are starting to understand that they are too far removed from care delivery to really assist members, especially high-risk members, in navigating both care and lifestyle issues.

Banner|Aetna began as an accountable care organization (ACO) and has become one of the most successful joint ventures between a health system and health insurer, expanding to the Arizona health insurance exchange in 2021.

We were also early adopters of the leading virtual primary care program 98point6 which we rolled out at no cost to most of our members. The app gives members 24/7 access to U.S.-based, board-certified 98point6 doctors who can diagnose, treat, prescribe medication, and order labs as appropriate and follow up. This program has been really well received, especially during the early pandemic, by members and employers.

Most recently, we’ve led the way in technology-enabled diabetes management by launching a new program with a company called Virta Health. Virta’s model is unique because they are using evidence-based medicine and virtual care to get people off diabetes medicines—and helping them reverse their disease.

Can you talk to us a bit about happiness and what makes you happy?
I love spending time with family and being outdoors playing tennis or golf.

It’s also important to me to give back, and this year I enjoyed chairing the Heart Walk for the Phoenix chapter of the American Heart Association which pulls the community together and gets us all outside for a great cause.

Contact Info:

• Website: www.banneraetna.com
• Facebook: https://www.facebook.com/Banner-Aetna-110066248278770/
• Twitter: https://twitter.com/banneraetna
• Youtube: https://www.youtube.com/channel/UCZYN4fgQfFGVxAUjfvU2P8A
• Other:
  https://www.linkedin.com/company/banneraetna/?viewAsMember=true
  www.linkedin.com/in/tgrote3/

Image Credits
American Heart Association