Dear fellow shareholders,

As we reflect back on 2021, we are proud of the great strides Signify Health is making to redefine how healthcare is delivered and paid for in the United States. When we filed for our initial public offering (IPO) in February 2021, we outlined a bold vision to drive transformation of the U.S. healthcare system from fee-for-service to value-based care. Our 2021 performance and March 2022 acquisition of Caravan Health have advanced us in realizing that vision.

We are a key participant and advocate in the move toward value-based care in support of The Centers for Medicare & Medicaid Services’ (CMS) stated imperative to have everyone in Medicare fee-for-service aligned to an accountable relationship by 2030. With our acquisition of Caravan Health, we now have value-based payment solutions covering a broad range of risk-based and shared savings models, from advanced primary care payment to specialty care bundles to total cost of care contracts. As a leader in this transformation, we continue to deliver meaningful value to our clients, facilitate improved clinical and financial outcomes, and provide challenging and satisfying careers for our dedicated employees and network of clinicians — all of which we believe will drive more value for you, our shareholders.

Using our deep analytics, broad networks, and proprietary technology platform, we enable value-based payment innovation to a diverse client base, including payors, health systems, providers, and employers. We raised over $600 million in net proceeds through our successful IPO, which enables us to continue to strategically invest in our business through technology, talent and additional products or capabilities, including strategic or tuck-in acquisitions.

Our 2021 financial results demonstrate our progress in serving our clients and are indicative of the trust they place in us. We generated revenue of $773.4 million for the year, an increase of 27% from 2020 and adjusted EBITDA of $171.2 million, up 37% from the prior year. Even as COVID-19 continued to create an environment of uncertainty, we successfully achieved our overall growth and profitability goals.

We owe much credit for our success to our employees — the ‘Signifiers’ who are inspired by our mission to do great things on behalf of the clients and millions of people we serve. They, and our experienced leadership team, tirelessly dedicate themselves every day to raising the bar for how healthcare is paid for and delivered. We are grateful for their efforts and contributions, and are confident that they will continue to be critical to our continued success and future growth.

Our businesses

We deploy our products and services within two operating segments, Home and Community services (HCS) and Episodes of Care services (ECS), with solutions across both segments leveraging our clinical and social care coordination capabilities, such as our Transition to Home service, to enable people to spend more healthy, happy days at home. We are building a multi-payor enablement platform to help connect payors to providers and bridge any gaps with technology, services, data, and our networks to drive alignment and better outcomes in value-based contracts.

Home and Community services

Our HCS segment drove our 2021 results, with revenue of $653.1 million, an increase of 45% from 2020, as our customers continued to turn to Signify Health for in-home evaluations (IHEs) on behalf of their health plan members. An in-home evaluation provides a holistic view of the individual and includes a review of each person’s medical history, clinical assessment, medication review, social determinants of health assessment, and preventative diagnostic tests. Last year, with our proprietary routing and logistics platform, we activated our provider network of over 10,000 highly credentialed physicians, nurse practitioners, and physician assistants across 50 states to perform more than 1.9 million IHEs on behalf of our Medicare Advantage, Medicaid, and commercial health plan clients, while significantly expanding penetration of our diagnostic and preventative services. We are focused on facilitating the return to care by helping individuals navigate a complex healthcare system and reconnecting them with their primary care physicians and specialists. Our clients continued to provide us with more IHE volume, a testament to the high quality of these comprehensive services — a trend we believe will continue to contribute meaningfully to our HCS business and future growth.

Episodes of Care services

In our ECS segment, we delivered significant savings in 2021 to CMS’ Bundled Payments for Care Improvement Advanced Model (BPCI-A), as well as to commercial clients, through our deep analytics and episodes engine. ECS revenue for 2021 was $120.3 million with a weighted average program size of $4.6 billion and a weighted average savings rate of 5.7%. COVID-19 and its variants created pressure on program size and the savings rate in 2021. Despite the ongoing challenge of COVID-19, our provider partners and the Centers for Medicare and Medicaid Innovation (CMMI) remain committed to the program.

Throughout the year, we continued to make significant investments in our commercial Episodes of Care business, where we have a first-mover advantage with our long experience as an original convener in the BPCI-A program. Our experience and analytics for procedural Episodes of Care are being expanded to include chronic condition management, which drives significant healthcare costs for both self-funded employers and commercial health plans. We have three anchor clients in three distinct geographic locations, where we continue to build out networks of distinction by expanding carefully curated provider partners.

With the March 2022 acquisition of Caravan Health, we anticipate the integration of total cost of care with our bundled payment model in support of CMS’ and our health plan clients’ roadmaps to address holistic care and health equity.

Environmental, social and governance

We remain focused on our mission to advance the transformation to value-based care. To that end, we developed a Statement of Purpose that defines our core principles, which drive our mission and vision.

We also were proud to publish our inaugural Quality and Social Impact Report, which outlines Signify Health’s commitments to improve the quality of our healthcare system; facilitate equitable care and treatment of all individuals; measure and report on the carbon footprint of our mobile workforce and corporate operations; and ensure that our efforts to increase shareholder value remain consistent with our stated purpose.

Board of directors

Signify Health is committed to ensuring that our Board has the right people and practices to effectively drive value for our stakeholders. Our board of directors comprises eleven highly qualified executives with a strong mix of finance, technology, and healthcare expertise to deliver diversity of thought, background and experience. In 2021, we added two new independent Board members, Heather Dixon, CPA, and Arnold Goldberg. Ms. Dixon’s background in finance and the healthcare industry and Mr. Goldberg’s background in technology platform architecture and product strategy add significant expertise and diversity of thought and perspective to our Board.

2022 and beyond

Signify Health’s strong business model and focused strategy firmly positions us to advance our mission and continue to grow. Looking ahead, we remain intensely focused on redefining how healthcare is delivered and driving systemic change across the broader ecosystem. We believe our continued investments in our people, analytics, and technology will help us to generate meaningful shareholder returns, deliver savings to customers, and enable better outcomes for the millions of people we serve each year. We thank our customers, employees, and you, our shareholders, for your ongoing support and confidence. We look forward to updating you on our continued progress in 2022 — and in the years to come.

Sincerely,

Matthew S. Holt Chairman of the Board

Kyle Armbrester Chief Executive Officer