SSM Health CEO Laura Kaiser on Building a Sustainable Healthcare System

After her first year with SSM Health, CEO Laura Kaiser talks about 'shifting our expensive rescue care system to one that is more broadly focused on preventive care, wellness, and affordability.'

This article appears in the November/December 2018 edition of HealthLeaders magazine.

The board of St. Louis-based SSM Health needed to find a blend of qualities when it searched for a new CEO in 2017. CEOs who can acquire more hospitals aren't that difficult to find these days, but leaders with a proven track record of getting multiple hospitals to work together are gold. SSM Health needed a CEO who was ambitious and yet grounded; after all, this is the first health system to win the Baldrige Award under the firm hand of Sister Mary Jean Ryan. And they needed a CEO who understood the values and people of the Midwest. Laura Kaiser hit every check on the list.

A St. Louis native, Kaiser took over as SSM Health CEO in May 2017 to replace the retiring Bill Thompson, who was an SSM Health employee for more than 37 years. Kaiser brought hospital leadership experience from many years running hospitals for Ascension Health in Florida and other markets. She was most recently chief operating officer at Intermountain Healthcare, what many in the industry consider the model for integrated delivery of healthcare.

In taking over SSM Health, she faced a system with a history of clinical innovation and quality that had experienced substantial regional growth in the previous decade, most notably the acquisition of Madison, Wisconsin–based Dean Health System in 2013, followed in 2018 by the acquisition of Fond du Lac, Wisconsin–based Agnesian Healthcare, and Monroe, Wisconsin–based Monroe Clinic.

Kaiser's first year hasn't been without tough choices. In November 2017, SSM Health announced the elimination of a few hundred positions or approximately 1% of its workforce.

HealthLeaders Editor in Chief Jim Molpus sat down recently with Kaiser at SSM Health's corporate headquarters to ask Kaiser about her leadership plans.

HL: What lured you to SSM Health?

Kaiser: I grew up in St. Louis and was very familiar with SSM Health. It provided a wonderful opportunity to return to my hometown and to my roots in Catholic health care. As a servant leader, I strongly identify with our mission, and it's what makes SSM Health such a special place.

Our first CEO, Sister Mary Jean Ryan, built a strong legacy focused on quality, diversity, and preservation of the earth. Bill Thompson, who followed her, continued that work and also began expanding our ministry. My focus is on continuing to grow, partner, and transform our ministry to ensure our patients and communities have access to high-quality, compassionate, and affordable care.

HL: Where do you see growth and partnerships fitting into SSM Health's future? How might it look different than SSM Health's regional expansion of the past few years?

Kaiser: Growth is one of our key strategic areas of focus. SSM Health has doubled in size over the past nine years and we will continue to grow and partner with others where it makes sense—to best meet the needs of those we serve. While much of our growth over the past few years has been through traditional transactions, we expect to build more collaborative partnerships in the future. Our partners will be both traditional and non-traditional, bringing clinical and healthcare expertise, but also experience in virtual care, technology, and human services.

HL: One of the changes with potential for the largest impact has been in governance. Your board grew substantially. Not many CEOs would eagerly embrace a larger board to deal with. Why the change at SSM Health?

Kaiser: In order to take full advantage of their skills, talent, and expertise, our board migrated from the Carver Model to a contemporary model.  We have also recruited several new board members, growing our board from seven to 17 which includes well-known and highly respected business, civic, and opinion leaders from our communities as well as across the country. By strengthening our board overall, we ensure strong oversight and direction for SSM Health.

HL: To "focus on the health and wellbeing" of an entire community is a huge statement. It's a goal every health system has somewhere in its mission. How do you make it real for SSM Health?

Kaiser: Good health and well-being has been a personal passion since the early '80s when The Aerobics Way was made popular by Dr. Kenneth Cooper in Texas. Helping each person live his or her healthiest life is obviously important for each individual, but it is also essential to shifting our expensive rescue care system to one that is more broadly focused on preventive care, wellness, and affordability. We all need to actively pursue this to create a system of healthcare that is sustainable in the United States.  

At SSM Health, this priority is consistent with our mission and strongly supported by our board. We have set specific goals to identify community health needs and then partner with others within our communities to improve overall health. We actively track our results to ensure we're making a measurable impact. It is difficult and critically important work.

Additionally, we are working to improve the health of communities through our health plan and various risk contracts, as well as employee wellness activities. Even something as seemingly simple as making it easier for our employees to make healthy meal and snack choices on our campuses can have a positive impact.

HL: At Intermountain, you had all the parts of the machine necessary to deliver integrated care: providers, payers, risk, data. You don't necessarily have all those same parts at SSM Health. So how do you make integrated care work here?

Kaiser: SSM Health is also an integrated delivery system pursuing the delivery of high-quality accessible services at an affordable cost. For example, in Wisconsin, we have Dean Health Plan, the SSM Dean Medical Group, several hospitals, outpatient and post-acute services, and a pharmacy benefit management company. All the ingredients are there, and we are continuing to build on those resources in our other markets as well. We've also added a Chief Clinical Officer to SSM Health to accelerate our work in care management across the enterprise, and this is work that will continue to grow over time.

HL: We feel a growing vein of frustration for health system executives over their IT expenditures and the value they get from them. Do you think that in the next few years we will finally see technology that can truly shift the paradigm of better care/lower cost? In what particular areas are you most hopeful that will happen?

Kaiser: There's no doubt in my mind that EHR systems have helped us improve patient care. When providers have access to complete and accurate information, they can provide better diagnoses and treatment plans, while also helping prevent medical errors. For example, EHRs keep a record of each patient's medications and allergies, and automatically check for problems when a new medication is prescribed. EHRs have also improved revenue cycle by enhancing our documentation and coding of claims, which of course leads to improved charge capture and reimbursement. 

Over the next several years, I expect EHRs to play a fundamental role in population health management. They will be used more and more in developing risk segmentation and standardized care management plans that offer the potential to further enhance outcomes and reduce costs, particularly for high-risk patient groups.

HL: How will SSM Health embrace a new relationship with the patient/consumer? How do you move the dialogue into areas that patients really care about, such as access and transparency?

Kaiser: Access and transparency are both very important to consumers. We must learn to meet people where they are and ensure our communities have affordable and convenient access to the right care, whenever and wherever they need it. That's one of the reasons SSM Health is working to further strengthen our ambulatory platform, expanding virtual care, senior care, postacute, and behavioral health services. This will enable us to provide access to the best care possible—at all stages of life.

At the same time, we have invested in technology and systems that make it easier to access our services, including online appointment scheduling, same-day appointments, and virtual visits with both primary care providers and specialists. Last year, SSM Health also launched a price transparency program that provides patients with their estimated out-of-pocket costs. At the same time, we began publishing physician ratings and comments from patient surveys on our website. These are just a couple of the ways we are trying to assist patients in making more informed decisions for themselves and their families.

Ultimately, we must work with our patients and communities to find out what they actually want and need from us—instead of telling them. This requires research and a lot of listening. We don't always get the answers we expect, and we have to be open to that.