Health system leaders are navigating one of the most turbulent stretches in recent memory, contending with funding cuts, workforce strain, affordability pressures, evolving payment models and the rapid rise of AI, all while trying to keep patients at the center of care.
For Laura Kaiser, president and CEO of St. Louis-based SSM Health, a 24-hospital system with more than 40,000 employees, the thread running through all of it is trust.
“To me it’s so fundamental,” she said. “It is the currency of leadership and relationships.”
Ms. Kaiser, who was recently named chair-elect designate of the American Hospital Association and is set to become AHA chair in 2028, spoke with Becker’s about how trust shapes every layer of the organization, from bedside nursing practice to enterprise partnerships to her views on where AI must never be allowed to crowd out the human touch.
Editor’s note: Responses have been lightly edited for clarity and length.
Question: You’ve spoken about tackling “wicked” challenges in healthcare and SSM’s transformation journey has touched nearly every corner of the organization. In the midst of that scale of change, what has anchored you most as a leader?
Laura Kaiser: It is all about faith and my sense of purpose. I really do view healthcare as a calling. When I think about SSM’s mission, vision and values, we have five values: compassion, excellence, respect, community and stewardship. Those align with who I am, and that’s wonderful because that doesn’t always happen for people in different organizations. I’m always looking for alignment because there’s a reason this is called work. But if you love what you do and you connect to the organization’s purpose, there’s so much more possible.
When I think of purpose, it makes me think of my parents. They instilled in me and my brother and sister to serve others. They were wonderful role models, and my life’s work is in healthcare, which I think is a noble calling for all of us who are called to it. I’m here to make a difference and have a lasting impact. It’s not about me. It’s about whether I’ve been able to help others. And there’s no shortage of challenges in healthcare to do just that.
Q: You’ve made culture a real priority, especially around workforce well-being. Can you share a moment when investing in culture tangibly improved the care or team experience?
LK: I’ll start by saying how I think about trust. I think sometimes it’s an overused term, but to me it’s so fundamental. It is the currency of leadership and relationships. If you don’t have trust, you’re not going to be able to go very far. That’s really why we’ve spent time at SSM building it over the past three years. We named 2024 the Year of Kindness because I felt like there needed to be more kindness in the world, and the accompanying leadership development work was about change management. The next year was about hope, which was also consistent with Pope Francis’ Year of Hope, and the leadership skills we built on were fostering trust using the Speed of Trust. This year, it’s the Year of Courage, and we’re deepening accountability, because all of it together is what enables us to lead change.
I have two examples to underscore that point, one personal and one inside our culture. When my stepdaughter was little, she and her little sister and their dad and I were all in a pool. She was about 5 or 6, and her dad wanted her to jump in. She had floaties on her arms and was scared. Her dad was in the water saying, “Come on, trust me. It’s safe. I’ve got you.” And she, in her little tearful voice, said, “I trust you, Daddy,” and jumped in. She would never, in a million years, have jumped in that pool if she hadn’t trusted her dad. That’s what trust is, and it’s true for all of us, whether we’re little kids or grown-ups.
The example from inside our organization is a nursing practice called Commit to Sit. The nursing leadership and team decided to institute it, and what it means is that in the inpatient and outpatient settings, nurses sit at eye level with patients to talk through their concerns, questions and experience. It fosters trust through active listening and being present, and it helps address concerns and improve satisfaction with the overall experience. That aligns with who we are as a Catholic organization founded by the sisters, the idea of being present for people, to accompany them.
Q: A core piece of navigating change is trust, something you’ve doubled down on with formal training and “The Speed of Trust” as a shared resource. What role has trust played in your ability to lead through both urgency and uncertainty?
LK: If people don’t trust you, they’re going to be more suspect about whatever your motives are and more fearful of whatever change is being discussed. Classic change management talks about the current state being unsustainable for whatever reason, and then the future state, which needs to be painted in a way that people can see it. In between those two is complete uncertainty, the valley of uncertainty, where there’s such a need for trust. Otherwise, there’s fear, there’s bad behavior, all kinds of things that can happen between being in an unsustainable current state and getting to the desired state.
For leaders, leading change is one of the most important things we do because it’s a constant, and fostering trust facilitates that. It’s really important for those we are serving and for all of us to be able to get to the desired place, because we’re all here to provide the best possible care for the people we’re serving.
Q: As SSM builds digital and analytical capabilities, how do you ensure that those investments don’t just improve operations, but also reinforce the mission and humanity behind your care model?
LK: Healthcare can be really impersonal. We’re a $5.3 trillion industry. We take 18 or more percent of the gross domestic product. We’re introducing new technology, including AI, and it can feel really impersonal and very big. For a patient or caregiver inside this gigantic industry, it can be dehumanizing. But the truth is, at its core, healthcare is about frightened human beings who are vulnerable and in a place where they need some help. They find another human being or human beings to help them. They bring themselves to a care setting, whether it’s a hospital or an outpatient clinic, and what they’re asking is for the human beings there to accompany them and help them work through whatever needs healthcare attention, and to hopefully help them get better. We can never lose sight of that.
AI and technology and all the things that comprise this industry are important, but it’s all because the patient should be at the center of every decision we’re making. Does this help the patient? Does this help improve care for the patients and families we are serving? We can get all swept up in the business of healthcare, but this is about the patients at the very core.
Q: Your early leadership with Civica Rx, a nonprofit generic drug company created in 2018 by a group of health systems and philanthropies, and ongoing focus on mission-driven partnerships show how collaboration can solve systemic issues. What kind of partnership, maybe one you’re building now, feels like it has that same transformative potential?
LK: I’m a strong believer in partnerships because there isn’t one healthcare organization — whether you’re medical technology, pharma, a hospital or a health system — that has this all figured out. Partnerships are incumbent on all of us leaning in to work together for the patients we are collectively serving.
With that in mind, I want to share about the Mindshare Institute, which is a new organization built around an old idea. Many of us who were involved in starting Civica Rx in the past are involved in it. It’s a nonprofit collaborative focused on identifying other market-based solutions, like Civica Rx, to address wicked healthcare challenges such as affordability. The Mindshare Institute is based in Utah. In addition to SSM, health system members of the Mindshare Leadership Council include Intermountain, Banner Health, AdventHealth and Ascension, and it extends beyond health systems to include Menlo Ventures, Harvard Business School and a former executive at the Aspen Institute. One recent announcement was about how to address air ambulance transport, which is pretty monopolistic and very expensive, through Aeroterra Health. How do we change that up, like we did with Civica Rx, to make it more affordable and accessible for everyone?
Q: You’ve said value-based care is about helping people live their healthiest lives. Where have you seen that translate into real decisions for patients?
LK: One of the ways to approach value-based care is to have a common definition, because when I ask people what they think it is, I genuinely wonder. There are so many different definitions. The formal definition is a mouthful: It’s basically a healthcare delivery model that pays clinicians and hospitals based on patient health outcomes rather than on volume. I try to make it simpler by saying we’re intending to help people live their healthiest lives, but it is about a different payment model.
The most tangible example I can give, because we’ve been on this journey for many years, is a patient example using diabetes. I have family members with Type 1 diabetes. In a value-based care model, the intention is to really address how to help someone live with diabetes and thrive and achieve their best wellness. That’s done through a multidisciplinary approach: There’s remote patient monitoring so caregivers and the team can look at data in real time and adjust medications if needed, because blood sugar can bounce around depending on lifestyle, movement, eating and sleep. The coordinated care team typically includes a primary care physician, an endocrinologist, perhaps a diabetes educator and a pharmacist, surrounding that patient to help manage their diabetes to the best ability possible. There’s also patient education, the electronic health record capturing different information, and regular measures like an A1C that tells you how well blood sugar has stayed in range, because too high or too low can have drastic consequences. When you’re in a value-based care situation, all of those are wrapped around the patient, and it’s less about how many procedures you’re doing and more about how that patient is doing relative to being as healthy as possible.
It’s a really good, concrete example that everyone would want for themselves or their family. So how do we build that and have an aligned payment system that aspires to do that for every individual, regardless of whatever disease or healthcare condition they’re trying to manage?
Q: If you rewrote your job description today, what’s the one bullet that wasn’t there five years ago and that most people still don’t realize is there? Can you give a specific example of what that looks like week to week?
LK: I would actually say two things. The first is advocacy, working with elected officials and lawmakers. It’s not entirely new, but the degree of time I’m spending on it is higher. By virtue of so many patients coming to us through Medicare, Medicaid and other governmental means, partnership with lawmakers is really important in terms of helping to educate on what is going well in the healthcare system and what needs to be modified, and to brainstorm together. That’s gotten even more emphasized in the past five years. It’s always been important, but I’m spending more time there, and I’m glad to do so because it takes me all the way back to the person, the mission. We’re here to help people, and so we need a system that works.
The other bullet that was not on my radar at all five years ago is agentic AI, and from the time we started this conversation to now, it’s already changed. I served on the board of Nuance before it was acquired by Microsoft, when they were developing ambient documentation for medical records. At the time, Nuance had voice recognition applications in automotive and banking, and they were working on what is now widely spread, DAX documentation in physician offices. The first time I saw a demo, I was breathless. It was so exciting, and I thought, “This is going to change everything.” It wasn’t perfect, but it felt real and possible.
Now, with it being so common across the system and the industry, even with that earlier experience, and that was now about eight years ago, I couldn’t imagine what is now forthcoming. I don’t think any of us could. We are all still learning about the potential. The power and the potential is very exciting, but there is also a need for us to be really thoughtful about how we as human beings help ensure that AI is used for good, and is used so that people who are called to be in healthcare continue to have their buckets full. We’re all better when we have joy in the workplace, and AI can help us be our very best for those who are counting on us to do so. That just wasn’t on my radar to the extent that I think it will influence our work going forward.
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