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EPISODES OF CARE

Commercial solutions

Drive greater healthcare savings, predictability, and satisfaction

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Pioneer a new path
to savings and optimal care quality

Overcome rising healthcare costs — all while improving the health, well-being, and satisfaction of plan members. Drawing on experience gained from managing $6.1B of spend under BPCI-A programs in 2019, we apply our unique blend of technology, analytics, and services to help you power a more cost-effective, high-quality system of care for commercial lines of business.

Accountable Alt

Full transparency

Proven

Guaranteed costs

Comply with Privacy Regulations

Prospective and retrospective models

Patient Segmentation

Shared risk arrangements

Access Clients Full History

Procedural and condition episodes

Optimal Program Design

Payment oversight and reporting

Who we serve

Partner with Signify Health to implement an episodes of care program that drives accountability and alignment along the entire care continuum. Our solutions apply unique experience managing value-based care programs for an array of industry stakeholders.

Address over 50% of annual medical spend
with guaranteed pricing

Seamlessly design, launch, and administer episodes of care programs covering the acute procedures and chronic conditions that represent over 50% of typical annual medical spend. Plus, gain greater predictability through guaranteed, fixed prices for all selected episodes of care.

 

Custom-design strategies and programs

Launch programs that address your unique needs. Drawing on our advanced data analytics capabilities, we’ll work with you to identify significant financial and strategic opportunities to design episodes, prices, and outcomes measures that deliver better clinical and financial outcomes.

 

Focus on care quality

Rest easy knowing that services are delivered with a focus on quality and cost. Our hand-selected networks of high-performing local providers work in concert with our field-based care coordination professionals to support patients’ holistic clinical, social, and behavioral needs.

 

Align incentives across the board

Enable meaningful collaboration with providers by leveraging our established relationships and unique provider risk-sharing model, which aligns incentives to focus on quality and price — and ultimately helps lead to happier, healthier plan members.

 

Empower providers to do their best work

Give the right providers the technology, information, and tools for success. Our solution offers site of care decision support, insights on the levers that drive quality and cost, and real-time data that enables early intervention and management across the entire episode.

 

Monitor activities and performance real-time

Access a comprehensive analytics platform that includes the latest episode costs and performance data at the individual beneficiary, provider, and program level.

 

Enable accurate payments

Partner with us to drive efficiency and accuracy for your value-based payment program. Our platform performs program reconciliations, generates reconciliation statements, and collects and distributes program savings and losses among payors and providers.

Advance your journey
toward value-based payment models

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Implement programs tuned to employers’ unique requirements

Move beyond point solutions that keep piling up and sometimes fail to live up to their promise. Partner with us to implement an episodes of care payment program and get guaranteed prices, a focus on quality care, and seamless coordination across all providers for a wide range of conditions and procedures.

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Accelerate value for ASO and fully insured clients

Advance the journey toward value-based care with a solution that aligns incentives for your clients and provider networks, backed by the nation’s largest convener by number of episodes managed. Leveraging learnings from our experience managing $6.1B in BPCI-A spend in 2019, we help you design— and implement — a solution for your commercial line of business.

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Use timely and actionable data to manage care across the entire episode

Leverage our technology platform, which enables a flow of actionable data to and from participating providers, to arm them with the critical data elements needed to quickly identify and better manage patients. We apply machine learning that analyzes demographic, eligibility, diagnostic, and other real-time clinical data to generate a score that accurately predicts the likelihood of a patient episode as well as risk factors along the entire care continuum.

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Address clinical and social care needs

Capture a 360-degree view of every patient throughout each episode of care and across all treating providers by marrying clinical, claims, and social determinants data with decision-support algorithms. Our advanced technology platform creates prompts and action lists for Signify Health social and clinical care coordinators to support front-line clinicians and help optimize patient outcomes.

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Manage cost with confidence

Apply the knowledge and experience gained working with more than 47 Medicare Advantage health plans and thousands of provider organizations to reduce variations in care, increase savings, and help patients enjoy more healthy days at home. And, we offer an array of alternative payment arrangements to support wherever you are in your journey toward value-based care.

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See how we're advancing value-based care

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Blog

The shift from volume to value is focused entirely on achieving better outcomes for the patient. Signify Health CEO Kyle Armbrester discusses the strategic imperatives for moving away from inefficient fee-for-service models.

News

The State of Connecticut is partnering with Signify Health to deliver value-based care for 220,000+ employees and their dependents with a program that includes a majority of physician groups and health systems in the state.

Blog

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.

News

Signify Health delivers prospective and retrospective payment models via recently-acquired blockchain technology to support clients wherever they are in their value-based care journey.

News

Cambia Health expands commercial episodes of care programs, including condition episodes and contracting with additional physician groups across Washington, Oregon, Utah and Idaho.

Drive greater healthcare savings, predictability and satisfaction.

Contact us to get started on the path to truly accountable value-based care.

Contact us