Signify Health President: ‘We’re Just Scratching The Surface’ On What Can Be Done In The Home 

Signify Health was purchased by CVS Health (NYSE: CVS) for $8 billion in March 2023. Now, it’s one of the core tenants of CVS Healthspire, the health care services segment that CVS executives are banking on to drive future growth for the company.

The Dallas-based Signify is a health care platform that combines technology, analytics and networks to create value-based payment programs, which are highly sought after in today’s health care landscape. The company is CVS Health’s connection to the home, reaching members through millions of in-home visits per year.

Paymon Farazi, the president of Signify Health, recently joined Home Health Care News’ Disrupt podcast to talk about Signify’s direction over a year after the CVS deal was closed, how the company could work with traditional home-based care providers in the future and where Farazi sees Signify – and health care – headed in the near- and long-term future.

Below is that conversation, edited for length and clarity.

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HHCN: Okay Paymon, I’d love to start with an overview of Signify Health for our listeners and readers.

Farazi: Signify Health has a mission that’s pretty common in health care: build trusted relationships that make people healthier. And we have a unique way of doing that.

We basically do in-home health evaluations; we’re going into over 3 million homes in 2024. And the purpose of those visits is to really meet members where they are, do a full, end-to-end assessment of their current health situation, and help them think about what the next steps on their health journey should be.

That’s the core of the product offering; it is free to members. We call and schedule appointments with members across Affordable Care Act plans, Medicaid plans and Medicare Advantage plans across the United States. It’s free to them, completely funded by the health plans, who are our clients.

One of the unique aspects of our company is we have many customers: the members, our customers; the health plans, our customers; the clinicians in the field, I think of them as our customers. I could go on and on. But we have to make all those constituents happy and pleased with that product, which is again at the core an assessment of that person’s health and giving them a path forward for how to take care of themselves better.

What has changed since CVS Health acquired Signify Health?

It’s been great.

The CVS health leadership team deserves a ton of credit for a lot, but two things in particular really stand out to me.

One was they started out by asking us, what other investment can we give you to help you achieve your long-term goals? So they poured a lot of money, a lot of investment into the logistics platform that helps run our whole business, basically putting people into homes across America.

And they put a lot of money into the clinical network.

How do we grow and maintain the very best clinical network in America? That is our aspiration.

And then the second thing was around how they could help us do things like partnerships across pharmacy and retail to bring greater value to our health plan clients.

They were really determined and insistent on us being multipayer business going forward, which we were in the first place. They wanted us to continue to enhance those relationships with other payers, like Humana, like Florida Blue, etcetera.

Overall, we’ve accelerated a lot of things we were focused on before the closing of the deal.

I want to dive into the in-home assessments a little bit further. There’s been a lot of research conducted about Medicare Advantage plans utilizing those, through companies like Signify. Similar to a traditional home health or home care visit, you see things related to a patient’s health journey that you wouldn’t see otherwise. Can you explain, from your perspective, the value of those assessments?

The first thing I would share is that I wish everybody listening could go do a ride along with one of our clinicians. That’s the best way to experience in-home evaluations and the value to the member.

I’ve done dozens of these at this point since I’ve been at Signify. And every single time I do it, I come out of it with this renewed sense of energy and purpose, because it’s so obvious the value that you provide to the member.

The minimum scenario is you’re connecting with a human being and listening to their health care issues. That alone provides tremendous value. And then we go above and beyond that by basically assessing what drugs they’re taking, highlighting questions to ask for their primary care provider. We’re giving them this end-to-end strategy on how to work on their health.

Anecdotally, it just feels amazing to do these visits.

To give you some numbers, our clinicians spend – on average – two to two and a half more time in the home than an appointment in an office setting.

What you can imagine is that extended period of time allows you to do, again, a much more comprehensive visit on health history – where things have been, and where they’re going.

I assume that it is nice to now be in a situation – for Signify and for patients – where patients can easily be connected to other health care services, such as primary care. There’s value in being able to bank on those connections, for all parties involved, no?

That’s exactly right.

Our clinicians are amazing, and all of them want to do something to help that individual. It’s not about just doing the visit and moving on, they want to make sure they’re taking care of themselves. And since we’ve been acquired, we’ve leaned into those kinds of partnerships with our sister companies, whether it be MinuteClinic, or the pharmacy, or Oak Street.

We did this huge program with Oak Street Health last year around finding members a primary care provider. We can get them scheduled for a primary care visit, and make sure that we close that loop. This is a product capability that we’ve built over the last several years, we call it care coordination pathways. Post-visit, how do we get you into the follow-up step, whatever that step might be.

I also imagine the more in-home evaluations you do on behalf of MA, those beget even more visits because entities are realizing the value of them. You’re able to show the results of patients previously visited in the home.

That’s exactly right. Last year, we closed almost 10 million care gaps across all the visits that we did. That certainly helps highlight the value of the visit to our health plan partners, and keeps them wanting us to do more of these things.

It’s about gap identification, but it’s also about a pleasant member experience – have the halo effect around the members. Letting them know that this is what it feels like to be a part of this health plan, to have someone in the home, to be connected to services.

Those things help contribute to potential growth. I will also add to that, while our core and our historical growth has been in Medicare Advantage, we are seeing increasing demand from Affordable Care Act and Medicaid plans.

You’re an Optum veteran, a company very much so in the home-based care game, through LHC Group and potentially through Amedisys here shortly. Humana is in a similar position with CenterWell. CVS Health owns Signify and Oak Street, while Walgreens backs VillageMD and owns CareCentrix. Why do you think this trend has materialized, and how will it change health care moving forward?

It’s a great question, and I think about this a lot.

And I believe we’re building these things because this is what members want.

I spend a lot of time with customers of various stripes, trying to understand what their needs are, where the pain points are, and then how we can help solve those. And one of the more obvious trends in health care over the last few years has been the realization that they don’t want to go into an office setting.

Some people want the visit to come to them.

And it’s all of us noticing this broader trend of how we make things more convenient, and help the person get care in their home rather than forcing them to go to another setting. And I believe that, as this happens at a greater and greater frequency, that the limiter will be around: How can you economically do that?

Because home visits can be more expensive. There’s a whole different apparatus of cost that you have to build in order to schedule 3, 4 or 5 million appointments, and that’s probably the rate limiter. But my hope is that as more and more demand comes from members and patients for these kinds of services, that economic picture will fix itself – and expand the number of services that can be done in the home.

If at all, how do you currently work with home health and home care providers?

We don’t today. But that’s something that is possible through the care coordination pathways product.

There’s nothing limiting us from doing that, other than conversations with our health plan partners and those entities to make sure that that’s turned on. I have had partnership conversations with different home health providers. And we’re starting to explore more of that in the rest of 2024. But nothing that has been sort of finalized at this point. But I would say again – the apparatus is built for it. So the only thing preventing us is making sure we find the right, most sensical partnership.

Where do you want Signify to be in three to five years?

To me, it’s really two things, at least from a product offering perspective. One is to continue to extend that core business. Can we try to do more visits across Medicare Advantage, the Affordable Care Act and Medicaid customers? That’s key.

The second is, can we do more in the home? And I would note two sub-themes under that. We do lots of diagnostic testing in the home, we call it our diagnostic and preventative services or DPS product line. We believe there’s a lot more room to grow in doing testing in the home. We want to do that at a larger scale.

And then the second sub theme under doing more in the home is are there adjacent services we could provide, like caretaking? What else could we send a Signify person in the home to do?

We’re actively in the process of figuring that out, so we can extend more services to our members.

And then, do you have a short- or long-term prediction for health care broadly that you can share with us?

The consumerization of health care will continue to make progress.

Health care companies will be focused on becoming more customer-oriented companies. That will drive us to do more of meeting the consumer where they are, which we believe again, is going to be in the home. They want convenience, they want things to be easier. So, you’ll see more and more of that.

Delivering meds to your doorstep, delivering care in the home. There’s so much more that we can do there. We’re just we’re just scratching the surface.

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