3 min read

Addressing PAD through Enhanced Clinical Services

Approximately 8.5 million people in the United States have Peripheral Artery Disease  (PAD), including 20% of individuals older than 55 years old1PAD often presents as leg pain during exercise that typically goes away after resting and is due to a lack of blood flow to the musculature relative to its metabolism. Most patients with PAD are unaware of the disease and attribute their leg pain to being out of shape, and not a chronic condition. It’s because of this misattribution that PAD presents a unique challenge. Medicare Advantage plans need a comprehensive picture of their members’ overall health status including conditions such as PAD. As a result, health plans are looking for new solutions to help diagnose conditions early in the disease process so proper interventions can occur. PAD is a strong predictor of adverse cardiovascular outcomes2 and early detection is important to institute risk factor modification to reduce adverse cardiovascular outcomes. Early detection may reduce morbidity by as much as 65%3.

The Importance of Peripheral Artery Disease Testing

As stated by the American Heart Association, Peripheral Artery Disease is a disease of the blood vessels outside the heart and brain. This condition is caused by a narrowing of vessels that carry blood to the legs and feet, arms, brain, stomach or kidneys. Fewer than 50% of PAD patients and approximately 30% of their physicians are aware that PAD is present4. Getting a test for PAD is vital for early detection and risk factor modification to reduce adverse cardiovascular outcomes. It represents a challenge for health plans as these members are often asymptomatic and unaware of having the condition.  

Social determinants such as socioeconomic status, ethnicity, and health literacy all play into the prevalence and diagnosis of PAD in patients. PAD is especially prevalent in at-risk patients, a primary focus for Medicare Advantage health plans, with a study detecting the condition in 29% of their panel5.

There are multiple reasons why PAD specifically represents such a challenge:

Increased Risks — PAD increases chances of cardiovascular disease, stroke, heart attack, and lower extremity amputation. It also has overlapping risk factors with diabetes—as well as preventative treatments such as dietary and exercise lifestyle changes. Early diagnosis allows health plans and clinicians to create a preventative care plan for the member.

Health Literacy/Lack of Awareness - PAD is generally less known in the population than general cardiovascular disease, strokes or heart attacks. This leads to a lack of understanding of underlying causes and symptoms, increasing associated risks.

Importance of In-Home Testing

Providing testing and evaluations in the home helps reduce barriers to care for members. Healthcare costs, literacy, and inconvenience lead to less physician interaction and a higher likelihood that an asymptomatic or misunderstood condition goes undiagnosed.

Providing in-home testing removes the member abrasion. In-home evaluations will often result in more face-to-face time with clinicians for both a more comprehensive exam and education. Our clinician network dedicates up to one hour with each patient for a health risk evaluation.  

Early Detection of PAD is Key

Signify Health’s Peripheral Artery Disease (PAD) Testing can be administered as part of our comprehensive and compliant in-home Health Risk Evaluation. We can truly impact the quality of life for health plan members while reducing avoidable medical costs.

If you would like to learn more about how our Enhanced Clinical Services paired with our comprehensive and compliant Health Risk Evaluations can truly impact the quality of life for your health plan members. Contact our team today.


  1. Fowkes FG, Rudan D, Rudan I, et al. Comparison of global estimates of prevalence and risk factors for peripheral artery disease in 2000 and 2010: a systematic review and analysis. Lancet 2013; 382:1329.
  2. Diehm C, Allenberg JR, Pittrow D, et al. Mortality and vascular morbidity in older adults with asymptomatic versus symptomatic peripheral artery disease. Circulation 2009; 120:2053.
  3. Lassila R, Lepäntalo M. Cigarette smoking and the outcome after lower limb arterial surgery. Acta Chirurgica Scandinavica 1988; 154:635.
  4. Novo S. Classification, epidemiology, risk factors, and natural history of peripheral arterial disease. Diabetes Obes Metab 2002; 4 Suppl 2:S1.
  5. Hirsch AT, Criqui MH, Treat-Jacobson D, et al. Peripheral arterial disease detection, awareness, and treatment in primary care. JAMA 2001; 286:1317

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