SSB is a partner to healthcare organizations looking to transform their care delivery models to accommodate the new world of value-based care. Our firm has facilitated planning and implementation of new clinically integrated structures--such as Accountable Care Organizations (ACOs) with CMS, Clinically Integrated Organizations (CIOs) for at-risk and perfomance-driven contracting with commercial payers. We have also facilitated strategic planning and collaboration for "Super CIO's", large at-risk contracting entities that bring together individual system CIOs into combined, market dominant networks that provide new opportunities to share the cost of infrastructure, technology and clinical expertise among and between providers.

In each project, SSB actively engages all stakeholders to:

- Define clinically robust and financially sustainable organizational models that provide a stable
   and collaborative platform for clinical integration

- Develop governance and management structures to guide and support these entities

- Plan and implement innovative care models to advance population health management, improve
   clinical quality, enhance patient access and service, achieve operational efficiencies

- Identify and reinforce core infrastructure and data requirements to support clinically integrated
   operations and strategic goals and

- Organize physicians to lead and support clinical quality and credentialing requirements across
   the care continuum

Against the backdrop of new payer strategies centered on "value-based" purchasing, SSB helps providers develop structures, strategies and networks that advance existing payer relationships and leverage emerging market opportunities. These new directions include planning and development of new value-based organizational and contracting structures (e.g., ACOs, CIOs, specialty CIOs and Super CIOs), formation of requisite delivery networks to optimize care management and coordination, and the active shifting of provider culture and operations to focus on population health management.

With respect to shifting to new value-based models, SSB brings deep expertise regarding:

- Structure and impact of new reimbursement models, such as shared-savings, at- risk
   and bundled pricing

- Strategic and operational planning for value-based contracting organizations addressing structure,
   governance, management, and technology priorities

- Analyzing value-based payer requirements with intent to align clinical focus and resources

- Working with physicians and hospitals to understand and plan improved workflow, integration
   and clinical quality priorities required by new value-based reimbursements and

- Facilitating network development and expansion, supporting physician contracting and outreach

SSB has extensive experience working with physicians and hospitals on physician alignment projects. Each project requires its own unique approach, but there are certain common elements to the services SSB can provide in the area of physician alignment, including:

- Interviewing physicians, listening to their issues, concerns and perspectives

- Analyzing the situation and developing an understanding of the broader context, including
   the market dynamics and other factors influencing the situation

- Zeroing in on the most critical issues that need to be addressed

- Identifying potential solutions for strengthening alignment

- Working with leadership on both sides to determine the most promising solutions to pursue,
   and an appropriate course of action

- Designing a process for obtaining consensus and buy-in from all key constituencies,
   including physicians and

- Implementing selected solutions

Identifying solutions and obtaining buy-in to a new direction is only half the battle. In this critical arena, ongoing, sustained execution of the strategy is what really makes the difference. SSB is prepared to work with the client in a variety of ways to ensure that the full potential for improvement is not lost due to ineffective execution.

SSB helps providers shape and grow their portfolio of clinical service offerings so that the organization is positioned to achieve its strategic, operational, and financial objectives. Our core areas of clinical expertise encompass cardiovascular services, orthopedics, neurology and women's health.

Projects typically begin with a thorough analysis of the economics of each clinical service line, in terms of direct and indirect contribution, revenue sources and uses, and cost structure analysis. It also includes an assessment of the mission of the sponsor organization, the demands of the local market, the interests and capabilities of the medical staff and projected trends in reimbursement. Our services in this area include the following:

- Service line market and competitive analysis

- Service-specific business plans

- Service line investment strategy

- Referral management and other volume building strategies

- Physician recruitment strategies

- Competitive differentiation strategies

SSB believes the ultimate achievement of a strategic vision requires not just a sound strategic framework for growth, but also a strong ability to achieve operational performance that supports growth while achieving financial targets. Superior operational performance cannot be achieved by hospitals alone, but rather must integrate and align physicians and their practice patterns. Accordingly, SSB consulting services in the area of operational improvement focus not just on specific aspects of operational performance, including benchmarks, but also on development of strategies and tactics that create and sustain physician support for change.

To support our clients' needs, SSB-both the core team and our extensive network of operational performance consulting partners-has developed an extensive array of operational improvement consulting services including:

- Quality monitoring and benchmarking

- Operational performance metrics

- Functional and operational analysis

- Process analysis and redesign

- Technology planning and alignment with operational processes and performance metrics

SSB believes that effective strategic planning must begin with a thorough understanding of each provider's underlying economics and market position. We have found this to be essential to effectively making critical decisions regarding strategic direction, competitive positioning, financial planning, service line and portfolio management, physician relations, managed care plans, and resource allocation among competing needs.

Our firm has worked extensively with hospitals, health systems and large physician organizations around the country to address near-term strategic priorities while managing toward longer-term goals. Our services in this area include expert analysis and facilitation of:

- Market-driven strategic planning

- Network/system development strategies

- Mergers and acquisitions

- Development of managed care strategy

- Economic and capital planning

- Program and facility planning

SSB provides a range of services to organizations seeking assistance with mergers and acquisitions. The scope of activities provided to clients ranges from comprehensive due diligence to facilitating negotiations to meticulous tactical and implementation planning.

Our work is grounded in developing a robust valuation of economic impact followed by rigorous planning to assess alignment of the various parties and the requirements for effective integration of operations. This is followed up by post-merger operational and strategic support to ensure the projected economic value is fully derived.

Key components of this work include:

- Feasibility assessments

- Identification, introductions and facilitation of discussions betwee potential partners

- Integration planning and implementation

- Integration and alignment of new leadership team

- Post-merger operational and strategic support