Specialist
Former VP at Signify Health Inc
Agenda
- Translation to value-based care dynamics and market expansion opportunities for Signify Health (NYSE: SGFY) to maximise margins with existing and new client base within its home and community services
- Renewed focus on HRAs (home risk assessments) and balance vs virtual visits
- CVS Health’s (NYSE: CVS) long-term strategy for Signify, discussing both companies’ transition to value-based care initiatives and long-term strategy to get ahead of the curve, including omnichannel healthcare services advantages, in-house risk adjustments capabilities and regulatory adherence risks
- CVS’ and Caravan Health's strategy to optimise success in value-based care arrangements
Questions
1.
What are some of the most important trends and developments you’ve been following in the home risk assessment market over the past year or so that might better inform our discussion on CVS’s Signify Health business?
2.
Could you share your high-level thoughts around the Signify Health acquisition by CVS which closed on 29 March 2023? Does this make strategic sense in your view? How does it fit into CVS’s short- and longer-term goals in the healthcare space?
3.
How can Signify benefit from CVS’s scale in other healthcare assets to maximise its long-term growth?
4.
What do you think are the most significant integration pain points or hurdles when CVS is attempting to seamlessly bring Signify into the fold?
5.
What are the main considerations around keeping Signify as payer-agnostic vs working with Aetna or a small number of large MCOs [managed care organisations] exclusively? From the standpoint of competing payers, do you see those sentiments shifting down the road regarding reservations around working with Signify as it becomes increasingly integrated under the CVS umbrella?
6.
How do you asses CVS’s ability to manage all these integration challenges, especially when trying to integrate a primary services company, Oak Street Health, alongside Signify? How do you gauge the company’s ability to manage cultural, operational and personnel risks?
7.
What do you think CVS’s grander goal or strategy looks like in the healthcare space? How do you see Aetna, Signify, Oak Street and the Health Hubs working together as one integrated omnichannel healthcare services offering? What’s the long-term strategy?
8.
How does Signify leverage predictive analytics to better assess patient risk scores and/or utilise SDOH [social determinants of health] for a more accurate risk coding? Could you provide a use case?
9.
How common are cancellation rates for Signify’s HRAs [health risk assessments] or home visits? What levers is the company pulling to increase engagement and reduce cancellations and other operational disruptions?
10.
What balance do you think Signify will strike between home and virtual risk in the longer term? How is it balancing the efficiency of virtual vs more patient data touch points and higher reimbursement for an in-home visit?
11.
Where do you see room for Signify to become more efficient on HRAs? How optimised is its process currently and how much room for improvement is there?
12.
Where is Signify vs where does it want to be on efficiency? Could you quantify any cost reduction levers to improve the margins on HRAs?
13.
How stable is the reimbursement environment for HRAs currently? Do you anticipate any shifts in reimbursement levels, delineating by virtual and in-home, respectively?
14.
What’s been Signify’s willingness to take on more value-based arrangements for HRAs?
15.
What are your thoughts on CMS [Centers for Medicare and Medicaid Services] increasingly cracking down on miscoding patient risk adjustment factor scores in the home setting? In light of that trend, what does CVS/Signify need to do in terms of quality control and regulatory compliance to maintain adherence to the volume in CMS guidelines?
16.
What’s your assessment of Signify’s Caravan ACO [accountable care organisation] business and its broader strategy as we move towards a value-based world? How does the Caravan asset pair with Oak Street?
17.
When might we see Signify look to move to commercial populations for outcomes-based arrangements? To what extent does having Aetna in-house give it more ammunition, so to speak, to be successful in value-based models?
18.
Do you have any closing remarks?
