Signify Strives to Find ‘Happy Medium’ of At-Home, Virtual and Clinic Visits

Signify Health (NYSE: SGFY) doesn’t know exactly how many in-home evaluations would be right for every senior yet, but it’s hoping to know soon enough. For now, it just believes that the more it can coordinate, the better.

“I think that is the holy grail of community-based medicine – the puzzle that needs to be cracked and solved,” Signify CMO Marc Rothman told Home Health Care News. “And I don’t think anybody’s gotten that right yet.”

Dallas-based Signify is a tech-enabled value-based care platform that partners with health plans and health systems, among others, to deliver care in the home.


In the third quarter, Signify said that it delivered 488,000 visits to seniors, the majority of which took place inside patients’ homes.

“You know, when you’re in the clinic, physicians ask if a patient is taking their meds and they say yes,” Rothman said. “When you go home, you get to see the [actual] pill bottles, and you can ask things like, ‘why are there so many?’ … You really get a sense of how challenging it is to manage [certain diseases], and can help them try to sort through it and simplify where they can put into place things that work. You just get to do a much more holistic assessment of a senior’s ability to manage and thrive in their own home.”

That increased visibility that in-home evaluations allow is why Signify has actually tried to cut down on virtual visits as the pandemic has subsided. While virtual visits remain a major part of its platform, they still don’t offer the comprehensiveness of an in-person evaluation.


“What’s the happy medium here, and how do you unwind this difficult knot? I think it’s really a mixture of home, clinic and virtual services combined,” Rothman said. “We don’t really know what the perfect mixture of that is today. But I would offer that I think the comprehensive visit into the home where you get to spend real time with patients is very important.”

Signify CEO Kyle Armbrester said earlier this year that patients have offered feedback on their visit preference, and that they prefer when they’re visited in the home.

Part of the reason why is likely Signify’s ability to address social determinants of health (SDoH) when they’re in the home . As of early November, the company had connected members close to 400,000 times with social services in their communities.

“During the pandemic, people were cut off from social support services,” Rothman said. “And so we really do a lot of focusing on social determinants of health. We have an incredible network of community-based organizations that we can then refer people to either indirectly or directly, so that the loop is essentially closed, and people can access the care that they need.”

Signify does those wellness assessments for SDoH for Medicare Advantage (MA) plans, but also does those evaluations post-hospital discharge.

“When we’re in the home, we’ll do a comprehensive assessment of all kinds of SDoH,” Rothman said. “That could be food scarcity or transportation [issues]. Is there any danger here of you being exploited or suffering elder abuse or neglect? Are you having trouble maintaining your roof over your head because of bills that can’t get paid, or are you able to access all your financial services that you need to access? Those are the types of things we can address.”

Signify has also avoided – at least partly – the staffing woes that have plagued other health care providers.

Like the aforementioned issues in health care that Signify is trying to address, the company stops short of saying they’ve found a definitive answer to mitigating the staffing crisis. But it does believe it’s headed in the right direction on that front.

It’s also cautiously optimistic that more health care professionals will be entering into home-based care settings in the near-term future.

“There was a trend over the last five or six years of practitioners trying to move towards the home – I’ve personally seen it in nurses, nurse practitioners and physicians,” Rothman said. “But now with the pandemic, that is accelerated. The home just offers an environment where practitioners can feel really good about connecting with patients. We see a pretty good opportunity to keep people engaged and retain them, as long as we offer them meaningful work. We also staff up, which is a logistical feat that we accomplished, making sure people have a full day’s work and a full week’s worth of visits that they can do.”

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