Signify Health is tapping into resources from parent company CVS Health to grow the number of in-home services it can provide.
Signify conducts in-home health evaluations for patients, and if needed, connects them to primary care or other follow-up services. It works with health plans to identify members who could benefit from an evaluation. CVS acquired Signify a year-and-a-half ago in a $8 billion deal, just a couple of months before closing a $10.6 billion acquisition of primary care provider Oak Street Health.
Related: Signify Health CEO chats acquisition, next partnerships
Joining CVS — which also includes the core retail pharmacy, insurer Aetna and pharmacy benefit manager Caremark — brought Signify into a larger ecosystem with opportunities to increase its care coordination offerings. In October, CVS ousted former CEO Karen Lynch, who oversaw the Signify deal and other efforts to diversify the parent company's assets.
That hasn't affected Signify President Paymon Farazi's plans to expand the kinds of services the company can provide as part of its in-home health evaluations. Farazi said in an interview his aspirations for Signify range from adding more diagnostic tests to moving into clinical care. The interview has been edited for length and clarity.
Does the recent upheaval at CVS affect Signify's outlook?
Not really. We have a very clear mission, a very clear strategy. At the end of the day, I need employees to keep scheduling appointments, driving clinical quality, doing the follow-up care. Just keep doing that, and we’ll add value.
Has Signify’s strategy changed since the CVS acquisition?
A little bit, in the sense Signify got far more serious about investing more dollars in what else we can do for patients in the home.
The acquisition has been a huge benefit to Signify because of the other assets we’ve been able to use. We have very close relationships with the pharmacy team. We had gone down the path of, can the pharmacists schedule these in-home visits? We had pharmacists doing that at CVS centers.
The other thing we’ve started to explore is care coordination and driving patients into the pharmacy. We need to refill prescriptions. That’s what people want. We’re trying to figure out how to refill them because there’s a tremendous amount of regulatory burden.
We piloted refilling prescriptions for statins, and it was a huge hit. Our intent is to continue to expand that ... with maintenance drugs where the patient already has a prescription.
What comes after an in-home visit with a patient?
Twenty percent of the time, a visit generates a referral that requires action by the health plan or primary care provider. The referral team makes sure there are follow-ups that go through the payer, especially because we have relationships directly with them.
We have an add-on that we call Care Coordination Pathways. It is a team of people who call to set up follow-up care. Signify has started to partner with provider systems like CenterWell and Oak Street to drive people who don’t have a primary care provider into those settings. We’ll schedule a mammogram. We’ll schedule vaccines. Care coordination has grown a lot over the last year.
How is Signify coordinating with Oak Street Health?
Signify is the number one referral engine to Oak Street. We started referring people to Oak Street when they didn’t have a primary care provider. I believe we can do even more to help them see health plan members. The challenge is getting the patient to come in for their annual wellness visit and for the follow-up care.
Oak Street has a robust disease prediction model, and so we deployed the model to a subset of people. We’ve been monitoring it carefully, and it's working.
We have never cross-pollinated talent with Oak Street in the sense that an Oak Street employee hasn't formally come and taken a role at Signify. But it’s going to happen. We have tons of informal conversations about best practices. How can we take the best of this, and the best of that, and build something better? I think there’s even more that will come as we take on risk for more lives through Oak Street.
What role does technology play at Signify, and how is it evolving?
We spend about $100 million on technology at Signify. We’re very tech-forward. A good example is the diagnostic screenings we do in the home. This is completely possible because of advancements made in the miniaturization of devices. The example I always give is spirometry. I did a spirometry test at a doctor’s office once. The machine is enormous. It takes up half the room. We have a device that fits in the palm of your hand to do this at home. We’ve been expanding the universe of things that we can do in the home because of technology.
Test results are seamlessly integrated with our app. We can collect the data and send it immediately to a vendor or a partner or a health plan, so they can take action. We have a team we’re investing in heavily to do more and more of those tests. Our intent is to basically keep expanding with diagnostic tests and see how far we can go.
What’s next for Signify?
The next year or so is going to be about increasing the number of services we can do in the home.
We’ve also started to explore splitting the evaluation visit up, so that we see the person more than once, which will allow us to do a meaningful visit one time and then, "OK, we missed these things. Let's go talk to you about diabetes only."
Years two and three is about how we further extend the services, perhaps going into areas that are beyond preventive care. Maybe clinical care, which is a really big hurdle to cross. To me, getting down that path is the ultimate goal. All of that will align with what Oak Street is doing, which is taking on risk for patients and helping manage the cost of care more directly. Every healthcare company should be thinking about care this way.
