Deepening Payer-Provider Collaboration to Improve the Patient Experience: John Byrnes

Achieving alignment between health care providers and payers can be challenging, but consistent collaboration and shared accountability can help keep stakeholders in health care aligned and improve overall care quality.

In this written interview with The American Journal of Managed Care® (AJMC®), John Byrnes, chief operating officer of Banner|Aetna, discusses his top priorities, emphasizes the importance of collaboration between payers and providers, and shares initiatives to help increase care access for patients. Byrnes, who has more than 15 years of experience in operations and strategy, stepped into the role in June 2025.

John Byrnes, Banner|Aetna chief operating officer

AJMC: What are your top priorities as you step into this role, and how do they align with Banner|Aetna’s long-term strategy?

Byrnes: My immediate priorities are to deepen payer-provider collaboration to solve big problems, continue to transform and improve the health care experience for our members, develop value-add employer-focused solutions, and leverage advanced analytics across our operations. That means building initiatives like our real-time clinical data sharing between Banner Health hospitals and Aetna care teams and expanding digital navigation tools to further support access to care and reduce member confusion. These efforts directly support our long-term strategy of improving affordability, quality, and the member experience through a truly integrated approach to care.

AJMC: How do you plan to accelerate or evolve Banner|Aetna’s efforts in value-based care?

Byrnes: Value-based care is foundational to our business. We’re accelerating our efforts by scaling targeted care models for high-cost, high-impact conditions and deepening alignment between clinical and operational teams. Our structure enables us to move quickly to address the unique needs of our members—whether that means closing rural access gaps through in-home acute care services, designing culturally responsive care for diverse populations, or partnering with employers on targeted wellness and condition-management initiatives that improve the health of their employees.

AJMC: What do you see as the biggest opportunity—and challenge—when it comes to aligning incentives between payers and providers?

Byrnes: At Banner|Aetna, we already see the benefits of trust, transparency, and shared accountability in how we operate today. For example, our joint governance model means payer and provider leaders meet regularly to review shared performance metrics, act on quality gaps, and co-design clinical interventions.

The challenge lies in that this isn’t the typical approach, and payers and providers are accustomed to being on opposite sides of the payment equation. But the benefits of collaboration, including improvements in care quality, make it worthwhile for both entities and more importantly, the patients and members they serve.

AJMC: How do you view the role of data and technology in improving care coordination and member outcomes?

Byrnes: Data and technology enable us to move from reactive to proactive care. Real-time insights improve navigation, unify care teams, predict rising risk, and reduce administrative friction. For example, predictive analytics now allow us to flag members at risk for avoidable hospitalizations and connect them with proactive outreach from care coordinators. As we continue to simplify the prior authorization process, we will further reduce the burden on clinicians, enabling them to focus on patient care.

AJMC: How is Banner|Aetna thinking about access, affordability, and satisfaction under your leadership?

Byrnes: We approach these as interconnected priorities. Expanding timely, relevant, and convenient access supports better outcomes—such as through our on-demand virtual care platform (98point6 by Transcarent), which offers primary care, behavioral health, care navigation, and other services to members, including those in rural and underserved communities. Our aligned cost strategies and performance-based models further improve affordability, delivering meaningful savings for both employers and their employees. And with our integrated operations, we support members throughout their care journey—whether that be through connecting them seamlessly to the right clinical services and programs or answering billing or claims questions clearly and quickly. Together, these pillars strengthen one another, driving improved outcomes, lower costs, and higher satisfaction.