In late September, St. Louis-based SSM Health and population health services provider Navvis entered into a partnership to design and operate a value-based care delivery model in the communities SSM serves.
Here, Carter Dredge, SSM Health's chief transformation officer, and Mike Farris, chairman and CEO at Navvis, discuss what the partnership will entail and what they hope it will achieve.
Q: Could you describe the value-based care delivery model that your companies will operate together, per the partnership? How exactly will it work?
Carter Dredge: At SSM, we're really committed to ensuring that our populations and communities get a holistic care experience, and we know that in today's world, too many things are very discrete and not as connected as they need to be. As we were looking at how to make this better, we really wanted someone that had a very integrated approach that could connect all the pieces together, and we found that in our partners at Navvis. They were very intentional on solving the right problems, on looking at the processes, looking at what really mattered to people, and [they] were really trying to reimagine the way health is managed across the entire continuum.
[The partnership] involves changing the financial incentives as we work more collaboratively with health insurance companies. It involves changing the way we look at care coordination across a broader set of interventions, and it involves changing the way we work and [incentivize] our employees inside to have everything coordinated.
That's really, at a macro level, what we are trying to achieve.
Mike Farris: Oftentimes, this is a hot topic, right? Everyone's talking about population health, everyone's talking about value-based care. The key to success is understanding what the population needs are, through deep discernment around analytics that allow us to understand both causal as well as correlative issues that can help frame us around the right programs and interventions that will address the challenges people face. [The challenges] that are actually contributing to the cost crisis of healthcare and also depriving many people from the quality of care that they desire.
These concepts of cost and quality, volume and value, oftentimes seems as though they are at odds with each other, but when you really approach it, as Carter described, holistically, what you find is that value is a function of appropriate cost, with uncompromising quality, and access is a critical point.
Q: The partnership involves the implementation of Navvs' advanced care management platform. Mike, could you talk a little bit about the platform and how it will facilitate the value-based care model?
MF: The industry has fallen in love with their solution called the EHR/EMR, when in reality, we need to fall in love with the problem and spend time on really understanding and solving the problem. And the problem isn't necessarily solved in the EMR. In fact, [Carter's] phrase is 'EMRs are a wonderful system of record, but they really do not provide what is needed as a system of engagement.'
Our approach to technology is to basically say "how do we enable all those who are in some way participating in care to be able to have information that is reliable at the right time and actionable in order to do what we do?" So what does that mean? That means, the technology has to be able to bring data in from every possible source you can imagine. Claims feeds, social determinants of health data, clinical data from the EMR, etc., and that technology has to be able to give you deep analytics. It has to sit alongside, in a companionlike way, the EMR, so the physician at point-of-care has the frictionless, seamless access to information that they would not otherwise see.
So that for the first time now, the physician sees at the point of care what's actually been happening with this person since the last time I saw them. Have they actually been to the emergency room? Did they get their vaccinations done at the local urgent care center? Did they have some other kind of event?
That information is very enriching. And as we think then about the continuum, the technology has to move with the patient [through different care settings].
Question: Carter, have you implemented the platform as yet? What were some of the most challenging aspects of implementation of the platform and/or model?
CD: Our partnership with Navvis is live now, and we are in the implementation phase currently. So, we're saying we will be fully functioning in early 2020. Really this comes down to leadership, and it comes down to trust and partnerships.
Change is hard, but [our staff members] are engaging because they can see that this is going to enable them to do what they wanted to do for many years. It's driving a lot of optimism.
The workload? Intense. The vision? Inspiring. Because [our staff] can see how these pieces have been disconnected before.
For the last few years, we have been messaging our commitment to a movement to value. We have been committed to this movement before we met our partners at Navvis, which I think is important. Once we met our partners at Navvis, we were already aligned because of the shared purpose and agenda we already had.
SSM has a culture of process improvement. We were the first health system in the country to win a Malcolm Baldrige Award, which is about continuous process improvement and design. So, this [partnership] really is very in line with our culture as an organization.
Q: What are the key benefits of the new model to communities you serve?
CD: We would expect to see more delighted patients because of a more frictionless and seamless experience. We would expect to see truly healthier populations because the care that they received is more coordinated. And then ultimately, we expect to have overall reductions in the cost of healthcare.
Speaking from a Quadruple Aim, we would expect that the people inside our organization will also have that continued greater sense of purpose.
MF: Our journey is intended to really address what this country's crisis is, which is access to care, the cost of that access to care and the experience that comes with it, believing that quality is a prerequisite to all of that. And if we can actually hit those objectives effectively, we believe we can create a bit of a contagion, by begin[ing] to demonstrate a model across the country that can really begin to change the trajectory of where healthcare is today and where it's going.