Breakthroughs - Navvis

SSM Health

BREAKTHROUGH PERFORMANCE
A system-wide transformation through population health that enables scale and high performance across unique and distinct markets

SSM Health is a fully integrated healthcare delivery system with a people- and population-centric approach. This ensures that all people have access to high-quality patient-centered care that is affordable and sustainable for future generations.

Revenue:

$9.3B

Markets:

Missouri, Southern Illinois, Wisconsin, Oklahoma

Lines of business:

Commercial (including ACA), Medicare (MA, MSSP, FFS), Medicaid

Network:

40,000 employees

12,800 physicians

23 owned hospitals, 33 managed/affiliated hospitals

290 ambulatory sites

13 post-acute facilities

520,000 insured lives covered by Dean Health Services Company (DHSC)

Breakthrough Results

Growth of value-based lives from 130,000 to more than 630,000

CMS contracts tracking to >4.5 Stars

30% improvement in care management productivity

20% decrease in post-acute care length of stay

Top quintile performance on key quality metrics

12% reduction in total cost of care

Tim Johnson, MD

Vice President
Clinical Integration

Published Case Study on SSM Health’s Journey to Value-Based Care

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At SSM Health, we are striving to provide the best possible care at the lowest possible cost, because we believe everyone should have access to affordable care. By partnering with like-mined organizations, such as Navvis, we can rapidly transform care delivery and better meet the needs of our patients and communities, including our most vulnerable and underserved populations.

Laura Kaiser, FACHE

President and CEO, SSM Health

HEALTH SYSTEM
PHYSICIAN ENTERPRISE
HEALTH PLAN

Esse Health

BREAKTHROUGH PERFORMANCE
Setting national benchmarks for value-based care performance; helping physicians preserve the joy of practicing medicine

Esse Health is an industry leader in value-based care. This independent physician group improves the overall well-being of its patients through education, lifestyle modification, and prevention.

Revenue:

$428M

Market:

Missouri

Lines of business:

Commercial (including ACA), Medicare (MA, MSSP, FFS), Medicaid

Network:

~200 Total Providers

165 Primary Care Providers

49 Locations

187,000+ Patients

Performance:

$100M value-based incentive payments in 2022

$76M value-based incentive payments In 2021

Breakthrough Results

4.5–5 Stars quality for each of the last six years

2023 patient satisfaction scores per CG-CAHPS in top 15%

Average Medicare spend per capita 25-30% below national average for each of the last six years

2018 AMGI survey ranked above 95th percentile in professional fulfillment

Erin Stamm

Chief Operations Officer

At Esse Health, we are committed to helping independent physicians maintain their independence. We help them streamline their workflows and offer the same patient support that has typically been reserved for much larger systems-owned physician groups. Physicians are relieved to have a high-performing practice and patients appreciate maintaining a one-on-one personal relationship with their independent provider. It truly is a win-win for all.

Rishi Sud, MD, MBA

Chief Medical Officer, Esse Health

HEALTH SYSTEM
PHYSICIAN ENTERPRISE
HEALTH PLAN

Healthcare Organization in Hawaii

BREAKTHROUGH PERFORMANCE
Achieving the nation’s first statewide implementation of value-based payment for primary care, with 99% of physicians moving to a contemporary value-based model

This healthcare organization’s mission is to transform health and healthcare for the people of Hawaii, creating an environment where families and communities enjoy ever healthier lives.

Revenue:

$4B

Market:

Hawaii (statewide)

Lines of business:

Commercial, Medicare, Medicaid, TRICARE

Network:

2,100 physicians

800,000 members

Breakthrough Results

99%+ of all PCPs participate in the model

Moved Medicare Stars Rating from 4.0 to 4.5

2.3 percentage point improvement in quality comparing PCPs who were transitioned to value-based payments with those who remained in FFS

11% increase in the quality of patient care and preventive services, with no additional healthcare costs

Increases in the percentage of patients receiving colorectal cancer screenings, mammograms, immunizations, and diabetic eye exams

CMS’ new payment models (January 2020) directionally aligned with the models and experience in Hawaii

Rachel Raquino

Market President, Hawaii
Navvis

Published Study on Payment Transformation in Hawaii

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Higher quality of care for my patients results in higher revenue, which is a win-win. I feel that payment transformation has decreased my feeling of physician burn-out, which will likely extend my career.

Craig Y. Hamasaki, MD

Primary Care Physician in Hawaii

HEALTH SYSTEM
PHYSICIAN ENTERPRISE
HEALTH PLAN

Partnership Examples

BREAKTHROUGH PERFORMANCE A system-wide transformation through population health that enables scale and high performance across unique and distinct markets

Tim Johnson, MD

Published Case Study on SSM Health’s Journey to Value-Based Care

BREAKTHROUGH PERFORMANCE Setting national benchmarks for value-based care performance; helping physicians preserve the joy of practicing medicine

Erin Stamm

BREAKTHROUGH PERFORMANCE Achieving the nation’s first statewide implementation of value-based payment for primary care, with 99% of physicians moving to a contemporary value-based model

Rachel Raquino

Published Study on Payment Transformation in Hawaii

BREAKTHROUGH PERFORMANCE
A system-wide transformation through population health that enables scale and high performance across unique and distinct markets

BREAKTHROUGH PERFORMANCE
Setting national benchmarks for value-based care performance; helping physicians preserve the joy of practicing medicine

BREAKTHROUGH PERFORMANCE
Achieving the nation’s first statewide implementation of value-based payment for primary care, with 99% of physicians moving to a contemporary value-based model