Corporate innovator: Victoria Bartolome, SVP of Strategic Initiatives at Signify Health

Steven Loeb · March 31, 2022 · Short URL:

Bartolome's role is to create an ecosystem through partnerships and expand the platform through M&A

While most entrepreneurs want to be the one to discover the next Amazon or Twitter, oftentimes major technological shifts are coming from the big companies, the players that have been on the scene for years, if not decades. Those companies have survived because they know how to pivot. They're the ones who either seed new ideas or acquire them and distribute them. 

In this column, we talk to those companies and their innovators who are preparing them for what's coming.

In our latest interview, we spoke to Victoria Bartolome, SVP of Strategic Initiatives at Signify Health. 

Signify Health is a company that uses analytics to promote a value-based care model. It provides in-home health evaluations (IHEs) for Medicare Advantage members. That allows its network of over 10,000 clinicians to better understand all of the elements of a patient’s life.

Bartolome has been with Signify since 2018, starting as Vice President of Corporate Initiatives, before transferring to her new role in 2019. Prior to that, she spent five years at Athenahealth in various roles, including Director, Product Strategy and Operations. 

VatorNews: The way we like to kick these off is by talking a little bit about you. Tell us a little bit about your background, your story, what led you to eventually join Signify.

Victoria Bartolome: My career actually started in the financial services industry outside of the US in Hong Kong. I was an analyst at CitiGroup covering the healthcare and consumer markets for the Asia Pacific region, actually, which is a completely different market from the US, but was a good foundational experience for me in understanding businesses, capital markets, as well as mergers and acquisitions. When I came back to the States, I made the pivotal decision to go into industry and wanted something that would tie with my passion in technology (I was a computer science major throughout college) and also blend in with my interest in healthcare. Both of my parents were in health care, my mom was a nurse and my dad was a physician assistant and growing up I spent a lot of time at their facilities getting ground level views of how they operated and how little technology supported their day to day. 

So, I found an opportunity to join a company called Athenahealth, based in the Watertown, Massachusetts area, on their business development and corporate development team. This was about the time of the Affordable Care Act just being passed with its mandates around meaningful use and the adoption of electronic health records and Athena was really at the forefront of providing cloud and web based technology to providers to help them with their workflow and insights to deliver care in a more patient centered and human centered way. So, my big focus at Athena, on the biz dev and corp dev side, was opening up that cloud based platform to third party innovators to seamlessly integrate and drive solutions for providers. I started Athenahealth’s More Disruption Please program and partner marketplace, which became a really nice differentiator for Athena as well as the lighter for clients. I also led some other strategic channel partnerships and acquisitions for the company that accelerated our revenue growth and also did some product management and strategy work on the heels of those acquisitions. 

After about six to seven years at Athena, I really wanted my next chapter and company to involve having a deeper impact on the shift to value-based care. That's how I came across Signify Health, which I thought was a compelling opportunity because of its focus on activating the home as a place for providers to engage and care for individuals and gain a more complete view of their condition, not just clinically but also looking at social, behavioral and environmental aspects of their living conditions. So I joined Signify back in early 2018, where my responsibilities have been focused on growing and evolving the business. I helped take the company public last year, and I head up our corporate development arm as well, focused on driving partnerships and acquisitions for the company to accelerate our growth.

VN: I was going to ask you to give an overview of Signify but you touched on that. So, I'm really interested actually in Signify’s solution, and especially the way it’s combining value-based care within in-home health. Can you kind of talk about those two aspects and how they work with each other? 

VB: Signify is really focused on convening people and convening networks to transform how care is paid for and delivered. So, we've convened a massive network of about 10,000 mobile clinicians composed of physicians, nurse practitioners, physician assistants, that we can deploy in the home to fully capture their condition, evaluate them clinically, socially, behaviorally, and activate proper follow-on care and interventions for that member. We've also convened large networks of provider organizations to partner in taking risk in value-based payment arrangements, whether that's upside or downside risk. And we also partner with payers as well in the design and success of those value-based programs. So, 

We're really this convener of networks, and really focused on activating the home in the continuum of care. So, as we leverage those networks to drive proper interventions, drive proper care, and address the needs of the individual holistically, ultimately those things all accrue to helping drive the right outcomes, both clinically and financially within value-based payment arrangements.

VN: So, you get the doctors into the home but how does that work, exactly? How do you facilitate those doctors to go in and do those evaluations and use the social determinants of health to lower the price of care? Where do you fit into that?

VB: We leverage a variety of capabilities against that. So, we leverage our technology platform, leveraging analytics to identify and target the right members to see in the home. We are activating services through our network of clinicians to go into the home, spend up to 45 to 60 minutes with an individual to get a comprehensive view of their condition. And, from there, we are activating proper follow-on care, whether that's social care through our network of social care coordinators. When we are in the home, we have this complete view of their medications from their cabinet, we can see if there’s food in the fridge, we can see if they have access to transportation, all of these social determinants of health are things that we can uncover as we engage with members during that hour long visit. And then we have resources through our partner community, through our networks that we've built and developed over time, to then address those needs, and help these individuals really manage their condition proactively.

VN: I'm sorry if I'm not totally getting it, I just want to make sure it's clear: so somebody needs to have an in-home health evaluation, their doctor needs to come in. So, you then go to that physician group and say, “We need a doctor to go into this home?” I just want to know how that this patient needs this and how the doctor finds out that need to go into this home and where Signify falls into that equation.

VB: Upfront, we essentially have a list of patients that we're analyzing and identifying who are the high risk members that we need to target. Those members we engage with to schedule the in-home health evaluation, and then we're activating our network of clinicians, whether that be a physician, nurse practitioner, or physician assistant, that's part of our credential network that we employ, so that 10,000 clinician network that I mentioned, to go into the home to see the member. And then if the patient hasn't seen their primary care doctor in a while, then we are helping the member reengage and return them to care. So, we are sending the information about the member to their primary care provider, and then also helping with the facilitation of booking the appointment back to see their PCP. 

VN: Talk to me about your responsibilities to the company, what are you in charge of, in your role as SVP of strategic initiatives 

VB: I'm really focused on two things in particular: as I mentioned prior, I was focused on evolving and growing the business from different angles, and then also helped take the company public. Within corp dev, specifically, I'm focused on really two things. Number one is how we can convene and create an ecosystem of innovative companies through our partnership program that we recently launched to better identify and address care needs in the populations that we see, whether that's activating them from our work in the home or around the value-based arrangements that we enable with our network of provider participants. And, number two, how we expand our platform through M&A to diversify our capabilities, our insight programs, and network participants in value-based care. So, a really good example of this is the Caravan acquisition that we recently announced just a year after our IPO, which diversifies Signify into accountable care and total cost of care models that we can integrate with our work in specialty bundles, episodes of care, where we can help manage costs at the condition or procedural level. 

VN: Let's talk about that partner program. I did actually write about this a little bit and so it would be great to do a deeper dive into it. As you said, your partner program is this ecosystem that you set up to connect value-based care solutions with all the players in healthcare. So, why was this something that Signify felt they needed to put in place? What was missing ? What was the gap that this now fills? 

VB: At Signify, we know that we can't do everything ourselves, and that we can move faster in our mission with innovative companies that align with us in transforming how care is delivered and paid for. Our clients are asking us to do more in and around the home, given that we have this comprehensive view of the individual, as well as the trusted relationship that we establish when our providers are in the home with the member. So, this program is really focused on developing an ecosystem of solutions that allow us to connect care and activate the right follow-on care for individuals, driving alignment amongst providers, and, most importantly, driving a more integrated experience for the individual at the end of the day. So, we're working with partners that are helping us connect individuals back to their PCP, as I mentioned, if they haven't seen a PCP for over a year, or connecting an individual to a mental health resource if we uncovered depression or anxiety from our behavioral assessment when we're in the home. So, these are all preventative, add-on services that, at the end of the day, can help avoid a hospitalization or a readmission, which helps save the rising costs within a value-based payment program.

VN: I know that you launched with seven initial partners. Do you want to talk about a couple of those companies? Who they are, what they do, and then talk to me about how exactly the partnership works. Give me an example of how you would work with those companies. 

VB: Quartet Health is a great example of a partner that we recently launched with to help serve one of our clients and their members in the Philadelphia market. Quartet has a platform focused on connecting individuals with behavioral or mental health needs with providers who can help them. So, during our evaluation in the home, we can assess and screen for behavioral issues, whether that's them having depression, anxiety, we ask about suicidality, and other needs. Prior to our partnership with Quartet, those needs were often going to a backlog with case management teams at the health plan and we would lose insight and not be able to track whether and how long it would take for those cases to get addressed. So, with Quartet, we launched with them late last year, and have amazing anecdotes so far of us identifying patients with mental health needs, activating Quartet to book an appointment in as quick as 24 hours, and getting that feedback loop that the member actually engaged with a behavioral health provider the following day. So, just great turnaround time in getting members to access the care that they need, and leveraging a partner to help us do that.  

It's just a win for everyone all around: the member has a better experience, at the end of the day their providers have a more connected experience, and our health plan clients are thrilled because that engagement can ultimately avoid a visit to the ED or hospital, which is part of the goal of any value-based program.

VN: Even before the pandemic there was a big change in the conversation around mental health, but especially in the last two years, a lot of people who have really suffered from lockdowns and the general stress of COVID and all that. Are you seeing an increase in the necessity for those kinds of mental health interventions?

VB: Absolutely. It COVID has really exacerbated the need here on the behavioral health front. We're seeing it expressed in our patient populations, it's why we wanted to find a partner like Quartet to help us fill that gap and when we see an individual that has this need to really connect them with the right provider. So many of us have been isolated in our homes, or places of residence, without an outlet or without having the right provider to speak to to help us with any of our behavioral issues. And so, this is a high need that I don't think is going away, even with COVID dissipating. At Signify we think it’s really important to incorporate that in how we manage patients holistically. We're not just looking at the clinical side; our assessments are meant to be more holistic in nature, looking at the social needs as well as the behavioral needs of patients. So, absolutely, it's a need that has risen, and will continue to stay and we're just thrilled to have a partner in Quartet to help us address that need.

VN: How do these partnerships help with advancing value-based care?

VB: These partnerships, as I mentioned, are really focused on activating the right intervention, the right next best action, whether that's getting the person to the right next site of care. So, for example, one of our other partners, Medalogix, is helping us identify rising risk around needs for hospice care or palliative care. So, these are individuals or patients that are going through a really tough time in their condition where the mortality risk is high, and Medalogix is helping us identify those patients so that we can activate the proper conversation around getting the patient to hospice care or getting them advanced care planning help or into palliative care. That ultimately helps avoid the patient going to the ED numerous times and going through this vicious cycle of incurring acute event over acute event, given that they're in this very fragile time of their lives and, in conjunction with that, also incurring costs associated with those visits. So, within any value-based arrangements, that's what you want to avoid. These partners are helping us not just activate the right intervention, the right next site of care, the right preventative service, that's the next best action, but they're also helping us upstream in identifying the right members, and the right moment in that members journey, to activate that follow-on care.

VN: From what you're saying, it seems like the population that you're focusing on are older people, people who are Medicare age, is that correct? 

VB: We do see a lot of Medicare Medicare Advantage patients, so we see a ton of seniors. We also see Medicaid individuals as well, which could include the under 65 population. And we also deal with commercial members as well in our episodes of care programs where we're working with employers and other payers to manage their patient populations, the under 65, within these episode based arrangements.

VN: Let's talk about value-based care. I think that a lot of people listening probably have some idea what it is; the way I always think of it is basically caregivers getting paid on the outcome of the patient versus just performing a service. How do you define value-based care?

VB: First off, the shift to value-based care is critical. The industry, for quite some time, for too long, has focused on this break/fix, fee for service model that's been volume-based in its approach, versus managing a patient's condition proactively to prevent high acuity, high cost events from triggering in the first place and escalating over time. And so, how I think about value-based care is that latter approach of proactive management and prevention. And that's critical, really, to saving our rising healthcare costs within the system and really critical to saving our healthcare system, ultimately, from the trillions of dollars of spend that it has escalated over time within that fee for service construct. 

And so, at Signify, we support providers and payers in their ability to care for individuals holistically, and, ultimately, succeed in that shift to value, whether that's participating in a bundled payment program, an ACO program, Medicare Advantage, or handling and managing their managed Medicaid program. As I mentioned before, we do that through the combination of technologies to provide insights and identify high risk patients that we should target and focus on drive the proper workflow around next best actions for the patient, and the right next sight of care, as well as other non-clinical needs, such as linking them to a community resource that can help them with putting food in the fridge or helping them with transportation or with the whatever the issue may be. And then, on top of that, we're combining the technology with services that we activate through our networks of clinicians, physicians, nurse practitioners, and and physician's assistants, as well as a network of over 600 clinical and social care coordinators that can engage with patients both in the home or virtually, whether that's to evaluate them, close care gaps, help them transition home and recover from an episode, or connect them with a community resource for those social determinants of health that we talked about. 

So, today, many provider organizations are understaffed or have issues with capacity and don't have the reach or technology to effectively and holistically manage their patient population. And payers, on the other side, are having challenges engaging their member populations, particularly those who are underserved or live in rural, hard to reach communities. Having a partner like Signify gives them that ability and confidence to not just participate, but also succeed in value-based programs, because we can really help move the needle in driving better outcomes.

VN: It sounds like what you're saying is, it's a move toward preventive medicine. Is that accurate?

VB: It's the move toward prevention. Medicine often gets pegged to medical treatments; we're looking at care more holistically than that, and treating patients in a whole person way. So, looking at their living conditions. Looking at, are they isolated at home? Do they have a caregiver or a loved one that's helping them day to day? Do they have a way to get to their appointments? Is their air conditioner working? So, a lot of these don't necessarily come to mind when one thinks about preventative medicine. And so, it goes a little bit broader than that.

VN: I guess medicine maybe has a negative connotation? If people hear medicine, do they have a certain reaction to that that maybe is not conducive to what you're trying to accomplish?

VB: No, it's not negative at all. It's a core part of healthcare. Care and medicine can have two different meetings: caregivers are not necessarily in the field of medicine, caregivers are part of the family, often, or a friend of that individual. So, it's more to say that when I think about value-based care, I don't necessarily think about medicine in particular.

VN: I was going to ask what those healthcare organizations are missing and, basically, what you said was they’re missing the technology and the way to reach their own members. Is it really that simple? They're just missing that way to reach out to their own members? I mean, these are really big companies. These insurance companies have so many resources, and they just have no way to actually reach their members? I find that a little bit surprising.

VB: I was a computer science major, like I said, throughout college and coming into healthcare, I was also surprised seeing these hospital organizations, health systems, and large payer organizations, ultimately, that were still very behind when it came to technology. I saw this front and center from my experience at Athena, as well. Many industries outside of healthcare are activating things within technology better, are just ahead of the game when it comes to leveraging mobile capabilities, leveraging AI, and advanced analytics, to engage with consumers. I want to see that more within healthcare, not just with health systems and providers, but also with payers. And so, we often link dollars and financial capital to the ability to have that advanced technology, but healthcare, at the end of the day, it's very complex and there's a lot of considerations around it in terms of privacy of data, the ability to share that data. 

This is something that we run into all the time at Signify, how do we leverage all of this data and insights that we're getting across the continuum, not just through the EMRs that we connect with and the other systems that we connect with from the payer, but also the insights that we're getting directly from the home and from the community? Leveraging that data effectively is a persistent challenge in health care because you run into the those roadblocks I talked about of how to manage through privacy and data sharing, and interoperability, because not all systems are on a level playing field of having all the interoperability capabilities that you would expect to see, necessarily. And so, just that data connectivity can present challenges. And, ultimately, technology is something where payors, they make the investments, but they're not necessarily technology companies at the end of the day. It's not their secret sauce, and they need partners like Signify, to help them with analytics and insights still, and logistics technology that we have to be able to deploy resources effectively across the country. So, it's that combination of technology, analytics, being able to use that technology and analytics effectively to put the right people in the right place in front of the right patient at the right time that payers often still struggle with. And that's where Signify comes in to help.

VN: It's been heartening to see them embrace the social determinants of health. They may not have the technology, and maybe the ability to really use that data, but they definitely want to. I mean, I've seen insurance companies in the last five years or so all of a sudden start paying for Ubers, and things like that, for people to get to the doctor. So, there definitely has been a shift in their mindset about what is healthcare. Where do you think that that shift is coming from?

VB: It's a very similar mindset that payers are adopting around care being more holistic, and thinking about preventative services that are not necessarily just clinical but also related to the social condition of the member or patient. So, it's just very promising to see that payers, as well as other constituents and stakeholders within the healthcare system, are getting on the train of thinking about whole person care, participating in value-based programs, and activating all of those levers around the clinical, social and behavioral treatments and resources that we can bring to bear for a member or patient at the end of the day to keep them out of the hospital or prevent a readmission and really start to bend the cost curve when it comes to value-based care.

VN: So, obviously, your big mission is to help those organizations transition to value-based care. How far along do you think that healthcare, in general, is in that transition? Are we in the early innings? Are we in the middle innings? Like how far have we come so far in making that happen?

VB: I would say that we're at least at the midpoint, if not further along. If you look at and talk to various companies within the healthcare space, nearly all of them have some goal or initiative around value-based care, whether that's getting some percentage of their patient population or membership, or having goals to move their patient populations into a value-based construct by some time period in the future. And so, I would say we're past that half way point. Value-based care has been around for at least a decade now in terms of it rising in importance to stakeholders in the industry. Many institutions have already gotten on board and in realizing that it's critical for the sustainability of the healthcare system, or their organization within health care, and really starting to be thoughtful about how to participate and increase their participation in value-based payment arrangements. And there's different vehicles to do that, whether it be through government programs, or commercial payer programs and Signify really straddles across the spectrum of both. And so, being able to partner with institutions across that portfolio, is really helpful because, as we talk to providers who are looking to participate more in value-based care, we can really come with that full spectrum that allows us to be a more meaningful partner for them in thinking about their patient population and how they can get into value-based care through those different programs that I mentioned, whether it be an ACO program, helping with their Medicare Advantage members, helping in episode or bundled payment programs, etc.

VN: Speaking of ACOs, you did bring this up earlier, I want to ask you about the acquisition of Caravan Health. Tell me about Caravan, about what they do, and how they fit into Signify.

VB: Caravan Health is a company that’s focused on enabling providers to participate in value-based payment programs, with a particular focus on accountable care models, or the ACO program. So, very similar to Signify: they're focused on helping providers join these collaboratives that they convene these providers into to spread risk, where it would be very difficult for these providers to participate in this model independently. So, they're aggregating lives as they aggregate these providers into these collaborative ACOs. And then, really supporting their success in the ACO model through technology, through insights, as well as practice transformation services and advice that they provide these community health systems. 

So they're very focused on this part of the market, being community health systems and clinics. Within those community health systems, they have about 10,000 primary care providers managing a population of about 500,000 lives. And so, we saw a lot of parallels with Signify in that Caravan is really focused on enabling participation in risk, whether that be just upside risk or two-sided risk, both with upside and downside mechanics. 

And then also really using this model of shared savings arrangements where they truly partner with organizations to share in risk and leverage technology and services to help those providers succeed. So we do that today at Signify through our episodes of care model, we've done that for our BPCIA clients. And so, there's just some very nice parallels between what Caravan Health has done in the market since their inception with what Signify Health has been focused on. So, we're very excited about the addition of their team to the Signify Health family. They really helped extend us from a value-based model perspective into accountable care and total cost of care models. And we can also integrate episodes of care and specialty bundles into those arrangements to help manage costs from a condition or procedural perspective.

VN: Talk to me about ACOs and how they differ from other value-based care models. What are some of the benefits of an ACO?

VB: Within an ACO, you're really focused on the total cost of care for a population that, as a provider, you're ultimately accountable for. And so, this is different from a bundled payment or episode arrangement, for example, where the anchoring construct is you're identifying patients as they go into the system, whether that they're going in for an acute episode or they're going in for a procedure and you're identifying that that patient is in an episode. We do that Signify through our analytics and the algorithms that we have around the episode definitions. And so, it's taking a more population-based approach to value-based care, versus the episodic construct that we see in bundled payment arrangements. Fundamentally, it's a different construct, being more population focused. And so, you get a broader exposure to the cost of care that you're managing for that patient population. It's not specific to a particular episode or condition as it is in bundles. So, you have this broader, more expansive opportunity to manage the cost of care for that patient population within your ACO. And then you can, as I mentioned, integrate specialty care, advanced primary care, and this episode construct to then dive deeper into a specific patient's condition and manage the span for that patient at the episode level or the condition level.

VN: What's the goal in adding Caravan Health? How's this going to change Signify Health and the way you approach value-based care?

VB: I would say that the benefit of this addition to Signify is really multifaceted. So, one, it diversifies our portfolio in offering a comprehensive platform and solution set that supports a really wide variety of value-based payment solutions. So, we can attack episodes and bundled payment arrangements, we can now address total cost of care risk arrangements, and then we can also look at advanced primary care and specialty care management as well. So, it really lends itself to Signify Health’s diversification strategy around value-based care. And it also gives us an end-to-end suite of value-based care enablement capabilities: our combined company will be well positioned to manage total cost of care through our combined suite of capabilities. Caravan Health really brings us population-based analytics and insights into our platform, they also have, through their platform called Caravan Coach, tools and and parts of their platform that really help with workflow and helping providers reach the right patients, care manage those patients, and help with managing chronic disease and conditions of those patients. And that, combined with Signify’s algorithms and our capabilities around episodes of care, it really develops and creates this end-to-end value-based care platform for the industry. We see this being a nice tailwind for us because, as we see the blending of these models potentially in the future of ACO and episodes, we believe that we can be the go to, leading enablement platform for providers that want to participate in that blended model that has elements of population-based accountable care as well as having elements of episodes of care as well.

VN: Can you talk to me a little bit about outcomes for the healthcare organizations and the payers that work with Signify? Obviously, there's a few different benefits to value-based care, one would be money saved for those organizations. Can you talk to me about that at all? Do you have anything that you can share on what the ROI is for them?

VB: The ROI for them isn't solely financial in nature. At the end of the day, we're helping our clients drive savings in their program, we're helping them manage risk, we're helping them manage cost of care. And so, financially, those savings are beneficial to our clients, but, ultimately, they're looking at patient satisfaction and member satisfaction, the ability to engage and reach their patients. So, from an outcomes perspective, it goes beyond the financial. We're looking at quality goals, we're looking at risk management goals for patients and numbers that our clients are responsible for. So, it really goes beyond just the pure financial and savings ROI; that is extremely important and core at the end of the day, but I would say the outcomes and results of the work we do is much broader than that. It ties to quality, it ties to engagement, it ties to a better integrated experience of their member patient population at the end of the day. 

VN: So, do they see their patients being more engaged? Are their patients happier when they use Signify?

VB: Absolutely, we see a lot of great anecdotes from the field. We have fantastic and very uplifting patient stories that we hear every day of patients that really got help from the providers that they saw, or from the engagements that Signify enabled. So, whether that was linking them to a behavioral health provider or helping them with a social need, we get stories day in and day out about that. So, that speaks volumes, and our clients see those anecdotes as well since it's their patients, it's their members. And we're seeing a lot of great engagement as well: our engagement rates, our conversion rates, continue to be strong and to increase year-over-year. We also see a lot of year-over-year acceptance of our evaluations as we do those annually with members in the home. So there's a lot of positive outcomes and results that we've seen across engagement metrics, and also just through these anecdotal stories that we get from the field day in and day out.

VN: What's the effect of value-based care on the doctor? We're always interested in seeing how that role is changing, how technology is changing what patients doctors see, and whether or not it's creating a situation where they see the patients who need them the most. Is that one of the outcomes of value-based care?

VB: Absolutely. We always hear about physician burnout and, for providers, they're really looking for partners that can help them focus on the high risk patients that they need to be focusing on and treating. They want more connectivity and integration with resources in their community. As I mentioned, a lot of these provider organizations are strapped right now; they're understaffed, they don't have the capacity to engage with members as long as they want to. I think many of us have heard the stat of the average primary care visit being 15 to 20 minutes, so many providers don't have the hour-long visit with the member, they don't get to see if there is food or in the fridge or if there’s lack of access to transportation. So, for providers, having a partner like Signify to really be an extension of their practice or organization, and go beyond their four walls, is beneficial for them. It gives them the confidence to really make that shift from fee-for-service to value-based payment arrangements, accountable care arrangements, where they really need to focus on quality and driving preventative services to the member and helping the member manage their condition more holistically, so that they're avoiding the hospital and the provider can be more sustainable, because, particularly as we saw the health system shut down through the pandemic, we helped many of our provider organizations to continue to see paychecks through their value-based care programs that they were participating in. So, it's a big part of providers being sustainable in their practice in the market and being aligned to where incentives are going around value-based arrangements.

VN: This has been a great conversation, and the way we like to always leave these off is by asking you to look into the future of care. We talked about the evolution of value-based care and where we are, and Signify’s goal is probably to have the entire healthcare industry be value-based. I mean, I would assume that's your end goal. So, what does the future of healthcare actually look like? Will it be value-based? And where will Signify Health fit into that ecosystem when we get there?

VB: I certainly see a world where value-based care is the industry standard. I'm certainly a glass half full sort of person and so I do see a future where that is the standard. And there are so many tailwinds today pushing in that direction, whether it be from a regulatory perspective, or from a client perspective. Our prayers, our providers, our employer clients are all working towards their goals to participate and grow their footprint in value-based care. So, it's very uplifting to see that there are initiatives across the board, as we work with our clients across the industry. 

I also see a world where patient care is delivered more consistently, and more holistically, and where the home is a setting that is more prevalent and at the forefront of caring about individuals and patients and that the home is thought of as a central place for care. Whether that's closing care gaps, or activating the right follow-on care from needs that are identified in the home. So, really, seeing it as an anchor point to drive better care coordination across the continuum. Signify Health, and particularly with our addition of Caravan, will remain a critical partner for providers and payers, because we have all of the capabilities and elements and ingredients for success to really help our clients be successful in these risk based and value-based payment models.

This interview has been edited for clarity. You can listen to the podcast of our conversation with Victoria below: 

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