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When Kyle Armbrester assumed the CEO role at Signify Health his reasoning was to move closer to actual health care.

After seven years at athenahealth, Armbrester stepped into his role at Signify Health in April 2017 and a little more than one year later the Company acquired Remedy to combine the worlds of home and community services with episodes of care as the industry transitions to value-based payments. Last month, Signify Health celebrated a significant milestone when they listed on the New York Stock Exchange under the symbol SGFY.

Health Evolution interviewed Armbrester about how Signify is integrating two different businesses, what to expect in the immediate and 3-5-year future, his advice for other CEOs, and more.

Coming from athenahealth, including serving as its Chief Product Officer, what attracted you to Signify Health?
Armbrester:
Over the last five plus years, there have been a number of shifts in healthcare that led me to Signify. First, data is ubiquitous in the market now — digital connectivity, including the interoperability standards pushed forth by the government, and access to clinical and claims data is much more commonplace than 5-10 years ago. Second, costs are just so out of control. We’re spending $4 trillion on healthcare in the United States, and the growth rate is outpacing even GDP. Medicare is in bad financial shape, employers can’t afford health care anymore, and there’s a lot of waste in the system — people are looking for alternatives, but not everybody has the answer. We need economic incentives with financial transparency to really make any meaningful change. On top of all that, we are seeing a shift back to the home. Healthcare was born in the home, and is now returning as a key part of the care continuum. The home is where people are the happiest, least stressed and most comfortable. By opening the aperture to have recovery in the home, we can cut out tremendous waste, lower costs and drive better outcomes.

When we formed Signify Health in 2017, we wanted to be a catalyst for changing the facility-centric, break-fix model of healthcare that leaves far too many clinical, behavioral and social care needs unaddressed. We’re helping our clients – health plans, employers – achieve real outcomes for their members and employees, and we’re sharing in the cost-savings that come from ensuring patients are getting care in the most appropriate settings. I am so proud to be a part of this team.

What are one or two of the most distinctive aspects of Signify Health?
Armbrester:
The first is that we have a physical presence with members. We are not engaging with people in the cloud. We’re in the community and in the home. The second is our scale. We work with almost every major health plan and all the large value-based health systems in the country. Our role is helping to connect the dots between those two rapidly converging worlds. We have a unique platform based on a long-term commitment to R&D that is driving value for plans, employers, providers and members. So we have an incredible ability to drive new technology-enabled services out of our core technology platform to continue to deliver value to customers. And it’s when we create value-based care with our commercial episode clients that we’re at our best and doing something truly unique.

On the face of it, you have two different businesses — home community services and then episodes of care. How do you bring those both together?
Armbrester:
They are different but equally necessary to achieve the holy grail in health care: to be able to engage people in the home, to be able to take care of their needs holistically – physical, behavioral, social — and to do this within a value-based framework to achieve better outcomes. It’s through our Home and Community services that we are able to help push through the colloquial “last mile.” I feel strongly that it is critical to bring together the clinical capabilities we offer along with our deep partnerships with social service organizations to address all of the factors that ultimately determine a person’s well-being.

Our Episodes of Care business addresses the cost and value of that care and provides the framework to align clinical and financial incentives to drive the behaviors that will lead to the best outcomes. We are the platform enabling the shift from fee-for-service to value-based care for all who bear financial risk. We partner with those entities and share the risk with our partners. If an episode results in a bad outcome, such as a readmission or deterioration in health and costs go back up, we lose money right alongside our partners. All of this is powered by proprietary technology and analytics, but we go way beyond technology alone. It’s the combination of our platform and what we learn from direct engagement with patients, face-to-face that separates us from the other players in this space.