Assessing and Meeting Patients’ Needs
Supporting patients and providers with payers begins with an in-home assessment of patients’ needs. Data analytics capabilities are focused on delivering decision support to all parties engaged in a value-based payment arrangement, especially with the primary care physician, to ensure access to appropriate, timely care and payment accuracy. How does this build trustworthiness? The organization must work with multiple parties including patients, providers and payers. This requires technical competence and integrity while doing it in a compassionate manner with the primacy of the patient at all times. and compassion.
How It Works
Signify Health’s mission is to transform how care is paid for and delivered so that people can enjoy more happy, health days at home. To achieve this requires us to build trust with the patients, providers, and payers to which we serve. Patients receive us in their homes – an explicit act of trust – to complete a Medicare comprehensive health risk assessment. Our specially trained clinicians spend an hour with each patient taking stock of their clinical, social, and environmental circumstances. We then support patients’ access to appropriate care by communicating with their primary care physician, their health plan, local community-based organizations, and through easy to comprehend instructional material. We provide our physician practice partners with advanced care management support and valuable data that helps them identify the most suitable site of care for their post-acute patients. We link patients and providers with payers in ways that ensure timely care, payment accuracy and compliance rigor. In all things, we emphasize candor, integrity, and compassion.
Skills and Competencies
In-home Health Risk Evaluations:
We connect clinicians to over 1.1 million Medicare Advantage and Medicaid plan members each year — wherever they call home — in order to create a complete and accurate view of their health. We help close risk and quality-based gaps in care through innovative workflows designed to evaluate health conditions, observe social and care-based needs, and deliver diagnostic and screening services with support from our nationwide network of nearly 9,000 credentialed providers, which includes physicians, physician assistants, and nurse practitioners.
Episodes of Care:
Bundled Payment for Care Improvement-Advanced: As the nation’s largest participant by number of episodes managed for BPCI-A, Signify Health offers trusted technology and support services that drive substantial Medicare savings and improvement to patient outcomes. We apply our unique blend of technology, analytics, and services to help healthcare providers make better-informed decisions and to create lasting change in how high-risk patients in acute and post-acute settings are managed. We collaborate with the patient’s interdisciplinary care team to support their recovery and stabilization, smooth care transitions, reduce avoidable complications, prevent inpatient readmission, and find the most appropriate care settings.
Commercial Episodes of Care:
Drawing on the experience gained from our success in BPCI-A programs, we work with health plans, employers and states to design, launch, and administer episodes of care programs covering the acute procedures and chronic conditions that represent over 50% of typical annual medical spend.
Social Care Coordination:
We connect members and facilitate collaboration with social service organizations within the community, as well as the broader health ecosystem, using a collaboration technology platform that complies with state and federal legal and privacy regulations. Our platform enables outcomes-focused networks designed to address social determinants of health, helping to close gaps in care and improving well-being through support for non-clinical needs.
Origins
Value-based payment programs are rapidly transforming how governments, employers, and health plans pay for healthcare services. The objective of these initiatives is to improve patient outcomes while lowering the overall cost of healthcare services. We were organized to advance VBP as a means of achieving the triple aim of better patient experience, better population health, and lower cost of care.
Effectiveness
Quite simply, the growth in our business is the best example of the trust we have engendered in those we serve. For example:
We have experienced a 27% increase in the number patients who allowed us into their homes (or via telemedicine during the peak of COVID-19) for health evaluations in 2020 over 2019
Our provider partners have increased the amount of medical spend we manage on their behalf under management in BPCI-A, with a 17% increase over the prior year.
Scalability
Our services are highly scalable. We support patients, providers and payers in every state in the US and can deploy our clinicians to any county within.