After last year’s spate of healthcare IPOs, more companies are lining up to go public in the new year. One of them is Signify Health, a Dallas-based startup that offers in-home care services and manages Medicare bundled payments.

Signify filed paperwork for an initial public offering with the Securities and Exchange Commission on Tuesday. The startup hasn’t yet set a price range for its shares, but estimated it would raise up to $100 million — a common placeholder number. It plans to trade on the New York Stock Exchange under the ticker “SGFY.”

Signify was founded in 2009, offering in-home evaluations for patients in Medicare Advantage plans and tools to identify potential social risks for patients, such as food insecurity or a lack of access to transportation. It recently made a string of acquisitions,  including TAVHealth, which builds networks of community health partners to better address patients’ social needs, and Remedy Partners, which collaborates with health systems to launch bundled payment programs.

Its customers include 26 of the 50 largest Medicare Advantage plans, and several healthcare providers, ranging from large systems to smaller hospitals. For example, Humana, Aetna and Optum are some of its largest customers, representing 26%, 16% and 12% of its total revenue respectively for the first nine months of 2020.

Bundled payment programs are also a big part of the company’s business. Signify builds networks of healthcare providers under the Medicare Bundled Payment for Care Improvement Program (BPCI), which ties a single payment to multiple services provided to a patient during a hospital stay or another episode of care. In the first nine months of 2020, these services accounted for about 25% of Signify’s total revenue.

From January to September of 2020, Signify brought in $417 million in revenue, up 13% from the same period in 2019. It incurred a $15 million net loss the first nine months 2020, down roughly 26% from the same period in 2019.  As of September 30, the company had $350 million in outstanding debt.

Like its health system partners, the pandemic has posed some challenges to Signify’s business. While it conducted little over a million in-home evaluations for Medicare Advantage plans in 2019, starting it April of 2020, it began to shift some of them to virtual evaluations.

As fewer patients sought care and elective procedures were delayed or canceled due to Covid-19, this also affected Signify’s bundled payment programs. Where the company managed 215,000 episodes of care in 2019, it saw a “substantially lower number” of episodes managed last year. This affected the startup’s revenues as Signify collects an administrative fee based on program size.

“Some of these measures and challenges will likely continue for the duration of the Covid-19 pandemic, which is uncertain…” the company wrote in an SEC filing.

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