Signify Health Exits CMS’ BPCI-A Program, Turns Attention to

In order to capitalize off its growth, Signify Health Inc. (NYSE: SGFY) will be shifting its focus to its home and community services business, the company announced last week.

It also plans to wind down its episodes of care services segment, and turn attention to its recent Caravan Health acquisition.

“Our [home and community services] segment is experiencing tremendous growth as our health plan clients have prioritized access to the home as part of their focus on closing clinical, behavioral, and social care gaps,” Kyle Armbrester, CEO of Signify, said in a statement. “Clients are seeing the value in our unique position: our ability to see patients in the home and refer them to care for the urgent needs we identify.”

As a company, Dallas-based Signify is a tech-enabled, value-based care platform that partners with both health plans and health systems to deliver a variety of care services to patients in their homes.

Armbrester noted that Signify is making investments towards operational improvements and efficiency. The company will also expand use of connected devices and diversify into new services.

In terms of the company’s work in the home, Signify’s home evaluations have been key in helping to determine social and behavioral needs. The evaluations also allow the company to perform diagnostic tests and other preventive services.

Plus, Signify also has a Transition to Home program, which is focused on driving better outcomes and more seamlessly bringing appropriate patients back into the home setting.

As far as Caravan Health, Signify’s leaders believe its acquisition of the company, which took place in February, will allow them to provide total-cost-of-care management services.

The Kansas City, Missouri-based Caravan Health works to help ACOs succeed in population health management and value-based payment programs.

Signify also announced that it will be leaving the Centers for Medicare & Medicaid Services’ (CMS) Bundled Payments for Care Improvement-Advanced (BPCI-A) program. This change is happening due to CMS trend calculations, which lowered target prices for episodes, and in turn, reduced the opportunity for savings.

“We made this decision in partnership with our clients, who have repeatedly surpassed benchmarks for quality care and operational improvements with our support – including significant reductions in readmissions and increases in healthy days at home during an extremely challenging period for healthcare,” Armbrester said in a press release.

Signify’s decision to end its participation in the BPCI-A program has to do with the Center for Medicare & Medicaid Innovation’s (CMMI) recent policies and its impact on BPCI-A pricing. The company believes these changes have made the program unsustainable.

“The BPCI-A pricing methodology has changed repeatedly over the years and has recently included the imposition of a retrospective adjustment that is not based on publicly available data, cannot be accurately forecasted, and is known only long after a performance period has ended, making it impossible to take real-time action,” the company said in a statement.

Currently, Signify is contesting the most recent pricing calculations. These changes will not impact the Caravan Health business.

Healthy