Marshaling Change: SSM Health Transformation Chief Tells Us How

Carter Dredge says mission, leadership, people, and a vow to self-disrupt are key elements in the health system's formula.

As health systems around the country adapt to new ways of doing business, SSM Health is charging full speed ahead. One year ago the organization recruited Carter Dredge from Intermountain Healthcare to serve as its new chief transformation officer (CTO).

Dredge's title and the groundwork he's laid during his first 12 months are indicative that the system is "taking an active stance to self-disrupt and be proactive about change," the CTO says.

In a previous article, Dredge shared the system's strategy of building business models to provide a focus for all transformation efforts. In this portion of the Q&A, he talks about what the system has accomplished, key factors in creating that success, and what he's learned along the way.

Based in St. Louis, SSM Health is a Catholic, not-for-profit health system operating in Illinois, Missouri, Oklahoma, and Wisconsin. The fully integrated health care delivery system includes 24 hospitals.

HealthLeaders: You've been in your role as chief transformation officer for a year now. What progress have you been able to make?

Carter Dredge: The first key piece of any large-scale transformation is you've got to have the right people at the table. We've done a fair amount to bring in people from around the country who are really engaged to make these types of changes. They are comfortable shaping ambiguity and are experts [in their fields]. We also have reallocated talent within the organization, transitioned people into new roles where we have a heightened focus. [Key areas of recruitment include]:

• People with extensive experience from the insurance industry to continue preparations to take on risk
   
• People with direct experience in innovation and business development, particularly related to partnership development

When we think about bundled payments, total costs of care contracts, or shared savings agreements, significant portions of that spend occur in the post-acute area.

• We've continued to heavily invest operationally in post-acute services, particularly those that have [the possibility to] reduce the cost of care across an enterprise footprint.
   
• We've purchased a residual interest in a company within our post-acute space, where we were already are a partner, but not an entire owner, so that we can go forward in a completely unified fashion.

In addition, we've doubled-down in some of our markets where we already are the insurance company, particularly in Wisconsin in some of those areas where we [operate as] an integrated delivery network (IDN).

I would sum it up by saying we've gone out and secured talent. We've procured some of the assets that we need. We've doubled-down on the IDN, and we've entered into several risk arrangements, some of them fairly sizable, that are multimillion-dollar impact in nature.

HL: What outside forces are driving change for SSM?

Dredge: Clearly, evolving consumer and patient expectations [drive change]. People are comparing us, as health systems, to outside industry players. There also are cost pressures on state budgets to drive down costs that we [must] constantly react to.

In the end, though, we are taking an active stance to self-disrupt, as needed, and be proactive about change. Even though we have external factors, we are proactively driving these changes, and we will predominantly be driven by an overall internal desire to make some game-changing moves.

HL: Let's talk about challenges you're facing.

Dredge: One challenge in a large health system, is prioritizing what fits into each big macro bucket. Organizations can maintain the core competency entirely and invest organically. They can choose to partner by taking on a minority partner to help accelerate the process, or they can choose to take on the role of the minority partner and cede the core operations of some of those aspects to a new or a larger player.

Those [endeavors] are way easier said than done. And it is one of the biggest challenges because doing things differently in a big organization is never easy.

HL: So you're also trying to change ways of thinking and behaviors?

Dredge: Absolutely. I would say we have some really strong alignment within the senior levels of the organization, and we're continuing to [make progress] throughout the rest of the organization. A key piece is that Laura Kaiser, our president and CEO, is a super high-integrity person. She's a super-fast paced person, and she is very open to new ideas.

No. 2, she's brought in several new people for the team. There are no major egos. I think this is very important.

And then, the overarching thing is that we are very mission-based.

HL: Your title is a little bit unusual, and your responsibilities cross into a lot of different areas. How do you marshal the resources needed to create transformation when all these departments are not under your purview?

Dredge: While many areas do not all fit under one single chain of command, it works because the people we work with have really high respect for each other, high trust, and low egos.

HL: What lessons have you learned along the way that might be helpful to others?

Dredge: Change takes longer than you think. It's really possible but only when you take that longer view and when you're willing to set aside personal aspiration or individual self-interest and just figure out how to accomplish the goal. In trying to figure out how to transform an organization, if a single individual tries to gather all the sufficient resources so that they unilaterally can make decisions to transform the organization, it's too complex, and it doesn't work. It requires teamwork, and it requires expertise, and maybe, above all, it requires a mission-centric view that our patients need something better.

Editor's Note: This article has be updated to clarify the response to the question about challenges, and to clarify the ownership arrangement in the post-acute care company.