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Building a Legal Department with Value in Its DNA

By Jennifer J. Salopek

SSM Health, founded in 1872 by five women, has long had a reputation as an innovative company; in fact, it was the first health care company to win the Baldrige Award. When Patti Williams was asked to join the company as its first general counsel in 2013, the invitation came with a heavy mandate: to reduce legal costs by 40 percent.

Although a very sophisticated $5 billion health system, SSM Health had never had an in-house legal department, relying on numerous law firms for all of its legal services instead. As Williams began to build a centralized team of in-house attorneys to handle its legal needs, she did it with value in mind. She also drew upon her awareness of the ACC Value Challenge as she worked to structure the department. She asked herself, What was the value of the work to the system?

“I wanted to have technology and value baked in,” she says. “We tried to eliminate low-risk, low-value tasks, and to assign risk-appropriate, high-value tasks to the new department.” These comprised such areas as credentialing, HIPAA, regulatory, and mission-critical areas.

SSM Health Group Photo

Yemi Adeyanju, Bradley Williams, Patti Williams, Matthew Pearson, Christopher Wintrode

Williams and Deputy General Counsel Yemi Adeyanju hired attorneys — ultimately 20 in a total staff of 32 — into practice groups related to health care operations, labor and employment, and transactions. In addition to the centralized staffing, standard operating procedures and robust metrics were established to ensure consistent, high-quality legal services.

Managing relationships with business leaders was a primary focus from the start. Williams and Adeyanju wanted to improve customer satisfaction from 78 percent to at least 90 percent. By quickly becoming more involved and engaged in operational issues, team members became more attuned to the specific needs of those business leaders.

“We heard from many of our internal clients that they really like their outside lawyers and feared service degradation upon bringing the work inside," says Williams. "We built the relationships from the ground up to have positive interactions from day one. We tried to reach out proactively, let people know how we could help, then expressed our gratitude and thanks when they turned to us.”

Now, internal clients enjoy faster service, greater consistency, and improved reliability, and have rewarded Williams and her team with a 95 percent customer satisfaction rating.

It was also important to Williams to create a collaborative, engaged team within the new legal department. She equipped them with all the modern technological conveniences, such as dual monitors and standing desks. The group also banded together to volunteer at local charity events. “Those activities helped us to bond, engage, and get to know one another,” says Williams, noting that these activities and others have placed the legal department in the 97th percentile related to employee engagement.

The Contracts Division exemplifies value and innovation from the inside out. Located within the Transactions Practice Group, the Contracts Division is a model unique among US health care organizations: This one-stop shop guides the request, approval, drafting, review, signature, administration, and compliance review for every SSM Health contract, including physician employment, vendor relationships, and real estate. The brainchild of Assistant General Counsel Christopher Wintrode, the Contracts Division is organized by service lines and uses self-service tools and forms on an intranet site, as well as electronic signatures, to streamline its contract review process. Improved legal staff efficiency reduced contract review time from eight business days to two; increased contract completions by 127 percent (more than 8,500 annually); and earned the department the SSM Innovators Award. A seven-step process guides the Division’s work.

Williams leveraged new technologies to establish a culture of innovation within the department, which is an entirely paperless work environment. The department utilizes an electronic contract management database to organize contracts and a cloud-based legal practice management program, Serengeti, to organize legal matters and approve invoices. Williams notes that simplicity is key to avoid being overwhelmed by the technology: “The [enterprise legal management] program comes with 400 options. We learned to turn off everything but the bare minimum. We use three templates,” she says.

In just two short years, the internal legal department at SSM Health has reduced its overall legal expenses by more than 65 percent through the insourcing of legal talent and improved control of external legal counsel. Outside counsel must participate in a standard fee schedule with safeguards to prevent fees from exceeding clearly defined maximums on hourly rates and total project costs.

From the Judges

“SSM Health reminds us why in-house law departments exist. Moving from a fully outsourced model, SSM Health created its first in-house legal department, driving down costs 65 percent, improving its contracting process, and ensuring customer satisfaction within the health system.”