SSM Health-Optum collaboration to use tech, data to aid patient care

Innovation will be a focus in improving processes, consistency of care and billing procedures to give patients better experiences.

A large St. Louis-based healthcare system and a technology provider are planning a unique collaboration to improve healthcare delivery as well as support patient access to care through digital technology.

The initiative involves SSM Health and Optum, a subsidiary that's part of UnitedHealth Group as the holding company; the October announcement came after months of discussion about the form of the joint effort.

SSM Health operates 23 hospitals in four states.

Close partner relationships between providers and technology providers have cropped up more frequently in recent years. The move to value-based care and other forces impacting the healthcare industry are increasing the need to innovate quickly, and these partnerships are seeking to find deliverables that improve data-driven operations and care, as well as develop capabilities that optimize care and system-wide efficiency. This most recent initiative aims to incorporate technology and innovation as they intersect with the people that use it and the patients who are served by it, executives say.

In their announcement, SSM and Optum said the collaboration aims to “improve the overall well-being of individuals and communities, while addressing the complex social and economic factors affecting each person’s health.”

The partnership will seek improvement in care and effectiveness in areas such as inpatient care management, digital transformation and revenue cycle management, with the intent of improving health outcomes overall and patients’ experiences with healthcare services. That will involve a redefinition of the typical patient experience by developing and interjecting a “seamless digital experience,” with the intent of improving patient access to care and services.

The collaboration also will result in a joint investment in community health programs to ensure access to care by the disadvantaged and vulnerable – efficiencies gained by closer cooperation will be thus re-invested to close health equity gaps in areas in which SSM Health operates facilities.

The commitment to such reinvestment is important for the provider organization, a Catholic, not-for-profit health system operating in Illinois, Missouri, Oklahoma and Wisconsin. SSM Health includes 23 hospitals and more than 290 physician offices and other outpatient and virtual care services.

Optum operates OptumHealth, which provides ambulatory care; OptumInsight, which provides data, analytics, technology and other services; and OptumRx, a prescription drug benefit provider.

Under the collaboration, SSM Health and Optum plan to:

  • Use clinical technologies, advanced analytic tools and data-driven insights at the point of care to reduce care variation in inpatient care delivery. 
  • Implement new and proven technologies to innovate and streamline the billing experience for patients and providers, thereby aiding the provider’s revenue cycle operations.
  • Advance consumer engagement by designing a seamless digital experience that simplify patient access to care and services.

SSM Health has a history of collaboration, and the partnership with Optum is emblematic of what will be key to improving healthcare, said John Nguyen, its chief strategy officer. “To transform healthcare, it will require people from all parts of the healthcare industry to work together. We’re looking at new and traditional ways or working together (with Optum).”

The use of technology and data is expected to play a large role in the shift to value-based care and improving consumers’ health, Nguyen added. “The efficiencies we’re hoping to gain, including being able to leverage tools, analytics and technologies, will help us try to lower total costs,” he said. “We plan to work on a more comprehensive and digital platform that all health systems will need to manage patients’ health in the future.”

Part of the effort to improve patients’ experience will be improving the billing process, said Ryan McKeown, senior vice president for market performance partnerships at Optum. The hope is to create a “frictionless billing experience” that will match patients’ requirements for simplified, no-surprise billing, he added.

Payment for healthcare services, which comes after care has been delivered, often colors patients’ overall perception of their experience with SSM, Nguyen added. “What we find is the real pain point…is the billing process at the end – it creates a lot of unnecessary churn for our patients.” The collaboration aims to create new solutions that can benefit the partners and the wider industry, they said. “We will be looking to see if we are reducing the total cost of care – are we improving the experience for patients and the providers of care,” Nguyen said. “Those two are fundamental. We hope that this partnership is something that paves the way for us as an industry. When all players get on the same page, we can move very swiftly in ways that we couldn’t have imagined previously.”

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