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May 11, 2021

Amid $564M IPO, upstart Signify Health has become a nationwide pacesetter in care analytics and management

Photo | Contributed Kyle Armbrester is Signify Health’s 36-year-old CEO.

A tech company with a deep Connecticut footprint has surged to national leadership in the exploding industry of home health evaluation and care management.

Launched in Dec. 2017, Signify Health Inc. offers a value-based care platform that employs advanced analytics, technology and a nationwide provider network to create and support payment programs that aim to move hospitals and doctor practices away from the costly fee-for-service business model in favor of contracts that provide incentives to keep patients healthy.

It’s a transition the healthcare industry has long desired, but progress has come slowly.

Signify’s technology aims to help its customers — including health plans, governments, employers, health systems and physician groups — assess and manage patient risk and identify steps to improve care outcomes, coordination and cost-savings.

It serves 47 Medicare Advantage health plans across the country.

Beyond analytics, Signify’s network of clinicians — predominantly physicians and nurse practitioners — physically go into patient homes to provide care. That number has trebled in three years from about 3,000 to more than 9,000.

Home care is an exploding market space — and an increasingly competitive one. As millions of Baby Boomers lurch toward old age, most of those not afflicted with chronic illness or debilitating mobility limitations desire to remain at home rather than retreat to an assisted-living facility or nursing home.


In the last decade, the number of U.S. home-care companies promising to help the newest generation of seniors stay at home as long as possible has exploded. Signify is one of those and its using its tech platform as a differentiator.

At the end of 2020, Signify had 35 million patient records powering the platform’s data chassis. The company says it performed some 1.4 million in-home and virtual evaluations nationwide in 2020, for a total “program spend” of some $6.1 billion under management.

When three years ago Kyle Armbrester, now Signify’s 36-year-old CEO, looked at the burgeoning home health-care market, he saw an industry segment that was potentially overloaded with competitors. He had just spent eight years at athenahealth, where he was senior vice president and chief product officer.

Signify Health was formed in Dec. 2017 by the integration of industry leaders Censeo Health and Advance Health following the recapitalization of both companies by New York City-based investment bank New Mountain Capital LLC.

New Mountain Managing Director and President of Private Equity Matthew Holt said, "We believe Signify Health’s ability to leverage tech-enabled analytics, networks and services in the home together with financial incentives alignment will drive growth in value-based programs and improve health outcomes.

"Signify Health is an excellent example of our focus on investing in businesses that can deploy technology to reduce inefficiencies and thereby cost, but at the same time improve quality,” Holt added.

Armbrester was there from the beginning.

“I really wanted to get health care into the fold and I wanted to [manage] and evaluate care contracts — contracts where you get paid for doing the right thing, and also you’re incentivized to cut out unnecessary waste,” he explains. “Those were my two big goals, and we’ve been able to achieve that on a dramatic scale at Signify. We’re in every county in the United States managing billions of risk dollars through our contracts.”

Investor support

Signify’s growth is broad-based and diverse. In Aug. 2019 the company acquired Norwalk-based Remedy Partners, which was created eight years earlier by Oxford Health Plans founder Steve Wiggins, for $405 million. Remedy is a provider of bundled payment programs. Both are portfolio companies of New Mountain Capital.

Signify’s principal executive office is in Norwalk, where it has about 110 employees. It also has large presences in Dallas and New York City. It employs 2,166 people overall.

This February, Signify began trading on the New York Stock Exchange following an initial public offering that raised $564 million. The company sold 23.5 million shares of its Class A common stock, which had an initial price at $24 per share.

Signify was the first Connecticut company to file for an IPO in 2021.

Late last year Signify announced a partnership with the state Comptroller’s Office to develop a “Network of Distinction” program for the state employee health plan, which totals more than 220,000 members.

The doctors, hospitals and provider groups in the network have agreed to fix prices for about 27 health procedures — including knee replacements, colonoscopies, cataract surgery and maternity care — moving toward what’s known as an “episode of care” payment model, rather than fee for service.

Essentially the program aims to prevent wild fluctuations in prices for certain care at various providers in the state and steer patients toward high-quality treatment locations.

Signify’s role has been to identify, contract with and support the network providers.

There are nine health systems/provider groups in the program, including Griffin Hospital, Prospect Medical Eastern CT Health Network, Prospect Medical Waterbury Health, and UConn Health-John Dempsey Hospital, Signify said.

State Comptroller Kevin Lembo has been a big proponent of the partnership, even congratulating the company after it went public earlier this year.

“The innovative partnerships established between the state health plan and private companies are sparking real change in the healthcare sector, emphasizing patient care and creating jobs,” Lembo said. “I’m heartened to see investors react so enthusiastically to the concept of compensating providers based on the successful outcome of a procedure — from evaluation through recovery — instead of rewarding sheer volume of services, regardless of the quality of patient care.”

It’s the first state-level public-private partnership of its kind, and Armbrester acknowledges it may be duplicable in other states.

Competitive edge

According to Armbrester, Signify’s competitive advantages are threefold.

“No. 1 is our people,” he says. “We’ve recruited some of the best talent from diverse backgrounds to come into home care. We are bringing new people who think creatively to drive new and innovative solutions. No. 2 is the fact that we’re working with value-based care. We really want to turn health care on its head by focusing on better patient outcomes. The third is our technology and our networks. We’ve built out an extreme advantage with technology and scale and efficiency throughout our business.”

The most objective measurement of Signify’s marketplace acceptance and growth trajectory lies in its financial performance.

The company grew its top line in fiscal 2020 by 22 percent to $610.6 million. For the fourth quarter alone, the company posted revenues of $193.5 million, an increase of 45 percent from the same period of 2019.

“These results reflect strong performance across all of our services and expanded growth with our customers,” Armbrester explains.

Notably, Signify says it spends $100 million annually on R&D. What do those dollars pay for?

“Analytics,” Armbrester explains. “We have people who deploy our resources when and where they’re needed most. We have teams of software engineers building out technology workflows to make sure we’re delivering the right care in the right place at the right time. And we have big product teams that prioritize and decide how and when and where we’re going to deploy our resources.”

In such a fast-changing industry it’s fundamentally an unanswerable question. But where does Armbrester see Signify in five years?

“In five years we will have dramatically rolled out commercial [solutions] containing unnecessary costs and driving superlative patient outcomes — making America a much healthier place than it is today. I want that for myself, for my kids, for my grandparents. We’re a big part of that solution.”

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