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Signify Health, a leader in accountable care and the 340B drug discount program, has announced its new success-based pricing model for 2022. ACOs have faced tremendous uncertainties throughout the COVID-19 pandemic, and Signify Health is supporting providers by eliminating all service fees and start-up costs to join its ACO program. By freeing providers from these costs and allowing them to collect a percentage of shared savings earned, Signify is positioning providers to better deliver high-value care. Signify Health works with providers to minimize their downside financial risk in the Medicare Shared Savings Program.

Signify Health’s success-based pricing model also extends to its 340B service line, where Signify Health helps ACO participants maximize their use of the 340B drug discount program with new value-based contract data and workflows. The service line can potentially enable ACO participants to earn more 340B discounts while helping hospitals and physicians expand primary care services for underserved patients with minimal risk.

"As Medicare and other payors are asking healthcare providers to take financial risk related to patient outcomes, it is critical that accountable care enablers not only provide the guidance, technology, and methodologies necessary for success, but also walk the walk, in terms of sharing financial risk,” said Rachelle Schultz, President & CEO of Winona Health. “Signify Health is that enabling partner. Their success-based pricing and shared risk model ensure they're invested in our organization's success. That is the type of confidence and assurance we need.”

Signify Health’s ACO participants consistently rank among the national leaders in performance measures. In 2019 and 2020, all Signify Health collaborative ACO participants earned near-perfect Merit-based Incentive Payment System (MIPS) scores, and in 2020, 100% of provider participants in the collaborative ACO model received shared savings. These strong results, combined with Signify Health ACOs actively managing the care of more than 500,000 Medicare beneficiaries, have led to the company’s management of one of the largest and most successful accountable care organizations in the nation.

Signify Health pioneered its collaborative ACO model based on statistical analyses that demonstrated the importance of having a viable number of beneficiaries being managed. Having more beneficiaries in an ACO results in less random variation, creating more stable and predictable financial results – results linked to actual improvements in care rather than the “luck of the draw”. In Signify Health-supported ACOs, independent providers band together to build a model that positions them to mitigate risk, achieve collective success, and improve patient outcomes. Providers, who would otherwise be too small to make total costs of care risk viable on their own, maintain their independence in a collaborative ACO, while benefiting from safety in numbers.

"A successful ACO requires joining forces with other healthcare systems, making investments in systems and staff, and adopting strong population health management. It can be difficult for providers to effectively line the pieces up, especially as the COVID public health emergency continues,” said Tim Gronniger, Chief Value-Based Solutions Officer for Signify Health. “Our model lowers the barrier to ACO participation while providing a sustainable path forward to earn savings and lower total costs.”

Signify Health accountable care organizations (ACOs) are leading health care organizations nationwide in the Medicare Shared Savings Program performance for another year, according to results released this week. Signify Health ACOs earned total savings for Medicare of $160 million, showing that Signify's collaborative approach continues to generate a return for population health investments.

All of Signify Health’s collaborative ACO clients, predominantly safety net and community hospitals, will receive shared savings, demonstrating the strength of our collaborative model. Between 2018 and 2020, Signify consolidated smaller ACOs into 12 larger ACOs to minimize statistical noise and variation that comes from small size – scale allows superior performance to shine through. Participating hospitals typically have fewer than 50 primary care physicians serving between 2,500 and 5,000 attributed Medicare patients which means they will struggle to generate shared savings revenue on their own.

Despite the enormous challenges of the COVID-19 public health emergency, quality performance was a strong point in 2020, with Signify ACOs earning scores averaging 97%. Following Signify's nearly perfect Merit-Based Incentive Payment System (MIPS) scores, these providers are well-positioned to excel in the coming move to the streamlined ACO Performance Pathways (APP) program.

"During 2020 and the onset of the COVID-19 pandemic, our clients showed ingenuity in serving their patients – using technology but more importantly grit and perseverance in making sure the most at-risk patients still had access to care when they needed it,” said Tim Gronniger, Executive Vice President, Accountable Care for Signify Health.

Frustrated by continued health plan inflation and point solutions that keep piling up and sometimes fail to live up to their promise, employers are looking for more comprehensive approaches that deliver measurable value today—and tomorrow. 

In 2016, 23 of Signify Health's Track 1 ACOs increased net patient revenue by 17 percent and saw an improvement in 14 of 17 quality measures. These successes were dependent on Signify's data-driven model.

Signify's approach draws upon our Enterprise Data Warehouse analytics to support care coordination and ACO Quality Reporting under the Group Practice Reporting Option. By merging standardized information with care management strategies, our ACOs can identify gaps in care and make necessary adjustments to workflow barriers for continuous improvement.

Signify Health analytics aggregates data into actionable reports, giving providers a deeper insight into their patients. Quality and practice managers can then analyze the reports to drill down changes at the patient level and identify improvements across all levels of the organization.

One Signify Health partner, Margaret Mary Health, has found success in proactively managing high-cost patients through data analysis. The health system can clearly pinpoint patients with high risk scores and excessive ED visits allowing them to implement new models of care delivery that will minimize inappropriate or unnecessary utilization.