The organizations

SSM Health is a large, integrated Catholic not‑for‑profit health system recognized for its quality and innovation. It employs 40K people and operates 23 hospitals and 300+ sites of care across Missouri, Illinois, Wisconsin, and Oklahoma. Navvis is a leading population health company operating across 12 markets and 100+ payer contracts. It provides analytics, clinical programs, and operational services to drive performance in VBC.

The result

SSM Health maintains 627,000 attributed lives, of which 58% are in shared savings and downside risk contracts.

SSM Health has also:

What made them successful

SSM Health grew its VBC footprint by building together. In 2017, Laura Kaiser became CEO and elevated VBC as a strategic priority for the organization. At this point, SSM Health was already participating in value-based arrangements, but leaders wanted to strengthen the organization's capabilities and expand across its four-state footprint. One of their earliest decisions was partnering with Navvis to build the infrastructure needed to support population health and risk-based contracts.

The partnership helped SSM Health accelerate several foundational capabilities at once. Navvis brought an analytics platform that combined clinical, claims, and contract data into a single view of performance, giving leaders greater insight into total cost of care and contract performance. The partnership also helped SSM Health scale care management programs, strengthen physician education through initiatives such as the Surround Care Academy, and provide hands-on workflow support through practice optimization managers. Together, those tools and programs helped clinicians and leaders turn VBC goals into practice.

As VBC expanded, the executive team faced a challenge common to large health systems: how to create consistency across multiple markets without forcing them into the same model. SSM Health addressed this challenge by standardizing core components of its VBC strategy while allowing markets to move into risk at different rates. The organization's physician compensation approach reflects that balance. SSM Health introduced a consistent model for primary care compensation. Every physician follows the same overall structure, but the weighting of value metrics flexes based on local market conditions. SSM Health later expanded the approach to specialists and APPs to further align frontline behavior with VBC objectives.

SSM Health learned an important lesson when its contracting goals began to outpace clinical capabilities. Instead of continuing to expand risk, SSM Health worked with Navvis and payer partners to reassess its pace of growth and give operations time to catch up. The organization also strengthened ties between contracting and population health leadership, giving both teams greater visibility into performance and ensuring future growth reflected what the organization could realistically support.

Partnership remained a consistent theme throughout SSM Health's journey. The organization worked closely with health plans through Joint Operating Committees that brought together clinical, operational, financial, and analytics leaders on a regular basis. These forums gave SSM Health and its payer partners a way to review performance, solve problems, and adjust course together.

Lastly, SSM Health learned that care management works best when its resources are protected. The organization regionalized care management across markets to keep care managers focused on population health work while creating more consistent support for patients and providers. At the same time, care managers remained aligned to dedicated PCP teams, preserving the relationships that make care management effective.

SSM Health's story shows what can happen when executive commitment is paired with the right partner. By combining SSM Health's clinical and operational expertise with Navvis' analytics, care management, and population health capabilities, the organization built a foundation for sustained VBC growth across four states.

Navvis is the leading value-based care enablement company, driving performance in value-based care and valuable volume. As an operating partner to some of the country’s most innovative health systems, physician enterprises, and health plans, we provide solutions that accelerate the journey to value-based care. Our approach is market-based — we respect the unique needs of populations in each community, including access to care, culture, values, and capabilities. Together with our partners, we set a new national standard in healthcare performance that delivers the affordability, quality, access, and experience that all patients deserve.

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This case study is sponsored by Navvis, an Advisory Board member organization. Representatives of Navvis helped select the topics and issues addressed. Advisory Board experts wrote the case study, maintained final editorial approval, and conducted the underlying research independently and objectively. Advisory Board does not endorse any company, organization, product, or brand mentioned herein.

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