Carter Dredge, senior vice president and lead futurist at SSM Health, opened his January 19 Leaders in Public Health speaker series presentation by sharing a personal story on why he became interested in health care innovation. Growing up in a four-generation household, he experienced firsthand the health concerns of his elderly grandparents and disabled mother.
“I was just surrounded by people who had massive health challenges,” he said. “And I just wanted to do everything I could to figure out if we could make life a little bit better for them.”
Years later, that drive to understand ‘why’ certain health care challenges exist – and to take action to try to resolve them – has become a fundamental component of Dredge’s innovative approach to large scale health care transformation – a process he refers to as “Disruptive Collaboration.”
During his presentation at the Yale School of Public Health, Dredge addressed the many challenges that exist when trying to change entrenched and massive-scale health care systems, and the unique approaches that are possible through new ways of thinking and partnerships.
Where are the areas in which we can do the things that are new and do a lot of them? And then, with the things that are old, where can we get together and make them happen in a new way that’s sustainable and scalable and cost-effective?
Carter Dredge
Dredge speaks from experience. In his senior leadership role, at St. Louis-based SSM Health, he advances SSM’s research and development, innovation, and new venture activities with a goal of accelerating large-scale health care transformation and ensuring more people have access to affordable high-quality health care.
“Health care, whether it’s in the form of delivery, payment, or public health policies, is complicated,” Dredge said. He cited several challenges that make changes hard to enact on a 1:1 scale or in a short time frame, such as an aging population, the need for greater productivity, labor shortages, and market failures or inefficiencies.
Rethinking health care often requires tackling large-scale public and private systems that aren’t easily altered, Dredge said. Furthermore, he explained, changes to these areas are not without financial impacts and – most importantly – genuine risks to life-sustaining essential services.
“If you switch away from one offering to another, it may not be a quick switch back,” said Dredge, who was recognized as one of the top 25 innovators in the U.S. by Modern Healthcare magazine in 2022.
Instead of being deterred by these obstacles, Dredge explores new methods to sustainably scale solutions beyond a small pilot phase to address the broader issues. He described how he finds inspiration in harnessing the ingenuity of private-sector entrepreneurial innovation and how those innovations can be channeled into strategies for affordable and equitable access.
Dredge believes we can utilize new business structures, tools, and models to address existing complex health care challenges from a novel perspective. That’s where the concept of disruptive and massive-scale collaboration comes into play, he said.
“In the case of disruptive collaboration, it’s not necessarily about having a new product, but it’s having a new way you work together, a new way to collaborate,” he explained. “But you do so at a massive scale because, again, when you’re dealing with these big problems, you have to have institutions on board to get to scale.”
Dredge also discussed the role of novel product innovation and intentional democratization, and how they are both needed to break existing boundaries.
“Where are the areas in which we can do the things that are new and do a lot of them?” he asked rhetorically. “And then, with the things that are old, where can we get together and make them happen in a new way that’s sustainable and scalable and cost-effective?”
One “big idea” in which Dredge has seen success is the Health Care Utility (HCU) model, an innovative business approach that operates under a different business incentive via disruptive collaboration.
Dredge defines a health care utility as “a self-sustaining, non-stock corporation with a social mission, formed by health care institutions to provide essential products and services at the lowest sustainable cost, using a focused, transparent, and scalable business model.”
The business model addresses four key components: structure and governance; financing and time horizon; goals and contract terms; and market positioning and scale. No one individual owns the company. It’s governed by stewards and financed by the same governing stewards who are also its customers. All customers get the same transparent and equitable terms and the health care utility operates in the open market in which the scale translates to sustainable cost.
These HCU principles provide the business foundation for Civica Rx, a non-profit pharmaceutical company established by a group of U.S. hospitals and philanthropic organizations that is dedicated to preventing and mitigating drug shortages. Dredge is a founding board member of Civica Rx, who helped create the company by engaging key players that already had demand and interest with the populations they were serving. He then asked those companies to rethink how to leverage long-standing and existing products and stakeholders to maximize access to inpatient generic drugs.
Through this innovative approach, Civica Rx was able to obtain contracts and aggregate a third of all hospital inpatient capacity in the United States to address an essential generic medicine-access problem. Dredge explained that the initiative succeeded by restructuring the business from a profit-based model to a model focused on maximizing access and equity.
“I’m not anti-for-profit businesses,” he stressed. “I think they’re critical when they’re developing new and novel technologies. The question is, what about when something is not new and novel?”
When considering what’s next in disruptive collaboration, Dredge said he plans to build more HCU’s and is finalizing details for an HCU incubator.
While his personal journey started by asking “Why” certain health care challenges exist, Dredge encouraged students and others attending his lecture to instead ask “Why not?” and to bring new vision to health care, business, and collaboration so that meaningful, large-scale, and sustainable changes become reality.
“There’s a lot of things that are untapped that we can do more of,” he said. “And it’s about sharing and going with those ideas.”
In addition to his other duties, Dredge is also co-founder of the Healthcare Utility Initiative, a global strategic initiative between the University of Cambridge’s Judge Business School and SSM Health, dedicated to improving access to affordable health care for everyone.
Dredge is also completing a PhD at Cambridge’s Judge Business School, where he was the first American accepted into the school’s business doctorate program.