Signify Health (NYSE: SGFY) is a home-focused organization. Therefore, CVS Health’s (NYSE: CVS) $8 billion pending purchase of it means the company is part of the largest home-based care deal of the year.
That deal is also one of the few this past year that have proven the ethos of home-based care. After all, the largest companies in the country – of which CVS Health is one – are investing heavily in it.
“We’re pretty excited about the opportunity to become part of the CVS Health organization,” Signify Chief Medical Officer Dr. Marc Rothman told Home Health Care News. “They bring just so many exciting capabilities and opportunities for us.”
CVS Health was undoubtedly making some moves into the home prior to the deal. But as it builds out its health care services, it needed a company that drove value and had more capabilities in the home.
That’s where Signify comes in.
“We feel like it’s a really great partnership,” Rothman said. “And we definitely feel like we have some resources and capabilities that they don’t have. And it should be a really nice, complementary match. The leadership team is excited. I’m personally excited. And I do think that our clients and our providers in the field are excited, too.”
The Dallas-based Signify is a value-based, tech-enabled care provider that leverages at-home health risk assessments. Its has more than 10,000 clinicians under its nationwide umbrella.
Caravan Health – which Signify acquired earlier this year – added significantly to its value-based care capabilities. Caravan partners with close to 200 providers participating in accountable care organizations (ACOs).
“This acquisition will enhance our connection to consumers in the home and enables providers to better address patient needs as we execute our vision to redefine the health care experience,” CVS Health CEO Karen Lynch said in a statement after the acquisition was announced. “In addition, this combination will strengthen our ability to expand and develop new product offerings in a multi-[payer] approach.”
Notably, UnitedHealth Group’s (NYSE: UNH) Optum is one organization that rivals Signify when it comes to at-home risk assessments. UnitedHealth Group made the second-largest at-home care purchase of the year, with its pending, near-$6 billion deal for LHC Group (Nasdaq: LHCG).
UnitedHealth Group and CVS Health also house two of the largest Medicare Advantage (MA) plans in the country in UnitedHealthcare and Aetna, respectively.
“It’s not the first time that a health insurer or someone big in MA has realized that they need to establish a better connectivity with what’s happening inside the homes of their members,” Rothman said. “But I think, just overall, what does that whole movement of the health plans into the home space tell you? It tells you that they appreciate that very little of a person’s total medical care over the course of their lifetime happens in the doctor’s office.”
Driving value, through the home
Rothman believes what the aforementioned deals show for the home-based care space overall is the commitment to value.
Value-based care has certainly been a talking point and a trend to watch for years. In 2023, however, he believes it will become less of a “fad” and more a staple.
“I think value-based care has passed the tipping point,” Rothman said. “I think it’s here to stay. I think you’re seeing more providers just finally accepting that they have to take downside risk. And you’ve got lots more organizations forming to help enable those things.”
One barrier has been providers’ willingness to engage in value-based models.
But the other is not on home-based care providers, he said. They can identify gaps in care all they want in the home, but if those gaps aren’t closed urgently, the desired outcomes don’t come to fruition.
“We’re finding all of these gaps in care that need to be filled,” Rothman said. “In Medicare Advantage, traditionally, you find problems in the home, and then you share that with the health plans, whose care managers largely are supposed to intervene on the member’s behalf. In the ACO value-based world, things that we find in the home should be translatable to instantaneous change, because we’ve got the PCPs and their case managers, and their MA is on the line.”
Rothman and Signify refer to this as “the next best action.” In other words, evaluating what can immediately be done to help with that patient and close that care gap.
That involves cutting through red tape at times, and also leveraging contract relationships to make sure what’s best for the patient is materializing after that recognition of an issue.
“Figuring out a way – whether we take that next best action or someone else in the ecosystem takes that next best action,” Rothman said. “That’s really where we’re focused in 2023.”
With its ever-growing provider network and its pending deal with CVS Health, that process should become easier and easier.