I had the pleasure of interviewing Kyle Armbrester.
Kyle is the CEO of Signify Health, the nation’s largest provider of care services in the home. During the COVID-19 pandemic, the Signify Health team has scaled operations and technology resources to redeploy thousands of physicians and nurse practitioners to be on the front liners where and when they’re needed most.
Our readers would love to “get to know you” a bit better. Can you tell us a bit about your ‘backstory’ and how you got started?
I grew up in Central Florida. I started my first company when I was in high school, building intranet and internet sites for various local businesses. That’s when I fell in love with technology and I went on to start a second technology company after college. When two of my loved ones became seriously ill one summer, I became their medical records department, handled their medical billing and helped coordinate their care. I saw firsthand how broken the healthcare system was. This experience stuck with me and is what inspired me to join athenahealth when I graduated from business school. I spent about eight years there helping to make cloud-based data a reality in healthcare — helping build a platform for moving clinical and financial and patient provider engagement data across the whole continuum of care. When I started there, the company was smaller. I helped it grow and I grew with it, eventually becoming part of the management team. When I left, the company was generating about $1.3 billion in top line revenue.
During this time, I noticed two big trends were happening. One was that convenience and access were dominating an individual’s decisions for how they wanted to receive and get care and dictating how they were choosing to spend their money, time, and resources to get that care. The second was because of that trend, the home was increasingly becoming a more viable place for care to be delivered. Based upon those two foundational premises and partnering with New Mountain Capital, the vision for Signify Health was born.
We started building out our clinical network, our social determinants of health network, and then our facility-based network via our Episodes of Care division to really tie all these things together. Our goal was to build a unique value-based, care-centric organization that drives happy, healthy days at home regardless of where we need to intersect or interact with an individual across their individual personal health journey.
Can you share a story about the funniest mistake you made when you were first starting? Can you tell us what lessons or takeaways you learned from that experience?
A lesson I learned early on was to avoid “death by a thousand cuts”, something which I found could very easily happen from doing too much customization on the software or project we sold to a client. I made a bunch of mistakes starting out doing bespoke work to support a one-off value for one customer. I learned that it’s really hard to productize something if you’re not very disciplined or stay focused on what’s driving systemic value across a broad array of customers. It’s why I’m pretty dogmatic now about being a product-led organization. You can be both product-led and customer-centric if you can distill through the signal-to-noise ratio and actually focus on what’s urgent and important that is going to drive the highest and best customer experience and value over time.
Is there a particular book that you read or podcast you listened to that’s really helped you in your career and can you explain?
When Breath Becomes Air by Paul Kalanithi. As I was starting to get deeper into my healthcare journey, something that became critical to me — and something that I’ve been proud that we’ve carried over to Signify Health — is the notion of humanity. How do we stay in touch with an individual holistically? How do we improve quality of life, not just improve the clinical state of being? The author was a surgeon with terminal cancer who wrote about his experience dealing with the tragedy and death of many of his patients while he was also dealing with his own impending death. For me, this book beautifully makes the point that we really need to take a holistic perspective when we’re thinking about healthcare. We need to go beyond the clinical because the issues we face as humans are multifaceted. They are social. They are behavioral. They can’t be taken care of just by focusing on the physical.
Extensive research suggests that purpose-driven business are more successful in many areas. When you started Signify, what was your vision, your purpose?
Our purpose was twofold. First we did not want to be just a clinical organization, we did not want to be just be an operational organization, and we did not want to be just a technology organization to address our mission in healthcare. We wanted to be a team who brought together a holistic approach of using technology, operations, clinical, social, behavioral and environmental aspects to lift up quality of life. I deeply believe that you need at least all those elements to have a shot at being successful in solving what’s broken today in healthcare. We are in tenacious pursuit of finding other elements to bring in to move our vision forward whether it is through our product roadmaps, our M&A focus, the talent that we have and with the talent we’re bringing in. I believe that home is where the heart is and that more happy healthy days at home will drive many of those things forward for many people in a very material way. We’ve slipped from that human focus in healthcare in a lot of ways. Getting back to that is one of the main reasons that Signify exists.
Do you have a number one principle that guides you through the ups and downs of running a business?
For me, it is don’t sit on problems. There is always going to be conflict, different points of view, and things that folks need to work through. I think that great leaders and great companies learn how to work through those issues in a productive way. They do not shy away from them or pretend that they are not going to arise. I have seen way too many teams try to put on a veneer that everything’s okay or that everything’s working just fine. There are always going to be mistakes. There are always going to be differences in perspective. One thing that I take pride in about my current management team, and in myself personally, is that no one is complacent. Always make sure you say something if you see something. I think that’s a super important principle to adhere to.
The COVID pandemic has affected nearly every aspect of our lives today. For the benefit of empowering our readers, can you share with our readers a few of the personal and family-related challenges you’ve faced during this crisis? Can you share what you’ve done to address those challenges?
We have a ton of heroes who are part of our workforce here at Signify — a large network of nurses, doctors, social care coordinators, post-acute/acute care managers, and countless other providers of care. We do care management and a whole battery of work that’s really critical to the lives and livelihood of those we engage with. Keeping that intact in a safe, appropriate, respectful and focused, outcome-centric manner was a tremendous amount of work for me personally, and for my team, throughout the last few months. It was a lot of long days and long nights pivoting our business model and ensuring that we were still able to drive that impact that we are so proud of.
On a lighter note, I have four boys — twin six-year-olds, a four-year-old and a two-year-old. Trying to coordinate all of them on Zoom classes and being in the house all day with them has led to its own series of repeatedly chaotic interactions. My hat goes off more than ever to all the teachers out there. I think everyone should be appreciative of the tremendous work and effort that they put into making all the students’ education really meaningful in this country. It is no easy task and I’m more appreciative of that than ever having gone through this, as I think many parents are.
What are the biggest work-related challenges that you faced during the pandemic? Can you share what you’ve done to address those challenges?
In addition to what I shared earlier, we have had to ramp up personal protective equipment, testing, screening, and many different safety protocols with a lot of oversight and deep clinical expertise around us to ensure that we’re operating as safely as possible to protect our providers and the members we were seeing in the field. And doing this with an outcome-centric point of view with respect to our clients and the individuals whose lives we touch.
Many people have become anxious from the dramatic jolts of the news cycle. The fears related to the coronavirus pandemic have understandably heightened a sense of uncertainty, fear, and loneliness. What are a few ideas that you have used to offer support to your employees who were feeling anxious? Can you explain?
I’ve been emailing employees weekly with extreme transparency on business model shifts and how we’re doing financially. We’ve been fortunate to keep a lot of our business intact and been able to give extra money to our employees for groceries or for donations to organizations they care about. I also think it’s dehumanizing in a lot of ways to be sitting on video calls all day, so I try to find ways to make the meetings I host more fun. Across the company, we’ve been doing virtual meet-ups, game nights, workouts and other activities to keep everybody communicating and connected. I’m extremely proud of the great leadership by our Spirit of Signify and Signify Cares teams in helping to keep all of us going with a little bit of levity through these trying times.
Obviously we can’t know for certain what the post-COVID economy will look like, but we can of course try our best to be prepared. We can reasonably assume that the post-COVID economy will be a trying time for many people across the globe, yet at the same time, post-COVID growth can be a time of opportunity. Can you share a few of the opportunities that you anticipate in the post-COVID economy?
I think things are going to be different until we have a vaccine. We’ll see social distancing, protective equipment, phasing in and out of closings and re-openings as information comes out. I think that all efforts need to be focused on testing, contact tracing, and vaccination. We also need to ensure that we’re continuing to build up and have ample medical supply capacity to handle any cases in a particular area.
How do you think the pandemic might permanently change the way we behave, act or live?
I think folks will wash their hands longer for sure. I also believe this experience will have a lasting psychological side effect on many people for quite some time. Humans are naturally social creatures. We thrive and seek out social engagement and I think many people will look to spend more time with loved ones. I also expect that we will rethink how we can enjoy sporting events, concerts and other activities where there are large gatherings. In the healthcare sphere, patient safety already was a big topic inside care facilities and I see that being amplified for the foreseeable future, which isn’t a bad thing.
Considering the potential challenges and opportunities in the post-COVID economy, what do you personally plan to do to rebuild and grow your business in the post-COVID economy?
I would say that I think we’re well suited for the post-COVID economy. We’ve always stressed that home is often where the right care is or where care should be. Our model is set up to support the healthcare system and the care teams working within it. We’re set up to deploy care nimbly and without all the constraints of a facility holding us back. Our ability to move, direct and navigate care in a safe outcome-centric way is going to be in more demand than ever.
Our business is doing well. We’ve been called to help the CDC and numerous manufacturing plants come back online by testing various cohorts of individuals across the country. I am very proud of our clinicians, our operations, technology, product teams and all working across the company for their ability to adapt and use all of the resources we’ve marshaled to make a positive impact. We have already seen an increased demand for our services and I believe that will continue going forward.
Is there anything you’d like to say about what you would encourage others to do as we prepare for the post-COVID economy?
I believe that staying positive and keeping a positive mindset is really important. I think doing things incrementally is important. We don’t need big bang openings and other things in my opinion. I think we need to ease into things, assess, ease in more, ease back. It’s going to be a constant push. I think people need to be patient too, right? We’ve got to go about this in a coordinated fashion as a group of individuals that are trying to make a positive impact. We’re not going to get everything right. We’re going to make mistakes and patience is a virtue as the old axiom goes. I think that’s going to be more important than ever both personally, professionally and at a societal level over the next few months.
Can you please give us your favorite life lesson quote? Can you share how that was relevant to you in your life?
One of my favorite quotes comes from William F. Halsey, Jr. who said, “All problems become smaller when you confront them instead of dodging them.” I really like this quote because it captures how I think about problems. Problems are part of life. They are unavoidable no matter how smart you are or what you might do to try to prevent them. So, own them, deal with them and move on. While I don’t think many people have the level of problems that Admiral Halsey experienced, they can turn into bigger things when we let them sit. My view is why let that happen when there are so many more productive things to focus on.
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