Roughly 2,100 SSM Health employees will transition to working for UnitedHealth Group's Optum subsidiary as part of an outsourcing relationship.
St. Louis-based SSM will fully outsource its revenue-cycle operations—the process of patient registration, billing and collecting money owed—to Optum, based in Minnetonka, Minnesota, under a 10-year deal that takes effect in February 2022. It's part of a broader agreement between the organizations that includes a collaboration on inpatient care management and an integrated digital platform.
Not-for-profit SSM is hardly the first health system to rebadge its revenue cycle workers. In fact, the COVID-19 pandemic lit a fire under the trend, which had already been underway prior to 2020.
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"I don't feel that SSM Health—or any health system, for that matter—has the expertise to do it all," said Laura Kaiser, SSM's CEO. "That's likely true for any organization in any industry. For me, it's more about, 'How do we partner with others so we can complement one another and seek alignment to best serve patients?'"
A Modern Healthcare investigation found that outsourcing revenue cycle and IT functions—while cost saving—can take a toll on internal culture.
The affected employees will work similar positions for the same pay, and Optum does not plan to cut any jobs, said Dan Schumacher, Optum's chief operating officer. SSM's revenue-cycle employees are currently working remotely—some due to the pandemic and some were remote pre-pandemic. Schumacher said the same is true for Optum's team.
Optum already has several health system clients in its revenue-cycle business, including Dignity Health, John Muir Health and Bassett Healthcare Network.
Of the 2,100 SSM employees who will work for Optum, about 300 work in inpatient care management, Kaiser said. SSM will also retain its own care managers, but the deal with Optum gives the health system access to Optum's "global talent pool, technology and analytics," Kaiser said. Together, she said the organizations hope to work on care variation and length of stay to better position patients for discharge.
"I think of this whole space of care management is like the holy grail of healthcare," Kaiser said. "If we're able to do this well together, there could be such an opportunity for improved health status for those we serve in a cost-effective manner."
As part of the deal, Optum has made a 10-year, multi-million-dollar commitment to funding community health programs for vulnerable populations across SSM's coverage area, which includes Wisconsin, Missouri, Illinois and Oklahoma. Schumacher declined to say how much Optum has committed.
