The growth in health care costs in the U.S. is staggering, making the sector an expensive and problematic proposition for individuals and families.
In 1960, per capita health care spending was $146; 20 years later, it was just shy of $1,100. Since 2015, health care spending per capita has gone from $9,880 to more than $13,000 in 2022, per Statista. The impact of escalating health care costs also bleeds over into the business sector as companies struggle to offer medical benefits to attract and retain workers.
Experts point to a variety of factors for the sharp increase, not the least of which is a dizzying array of administrative and back-office costs that are passed on to the consumer. Recognizing this fact, Signature Performance was born, offering a suite of products and services to help clients streamline administrative processes and realize cost reduction through efficiency.
“The total health care spend is about $4.3 trillion and going up annually,” said Chris Vairo, chief of staff. “Of that, about 40 to 42% of that total spend is now (for) the administrative part of health care; for every dollar, 42 cents are going just to administer claims. Twenty years ago, that was probably 15%. Our focus is driven towards helping reduce that health care administrative burden that’s taking place.”

Vairo joined Signature Performance in 2013 and in the time since has helped drive the company’s growth in the health care space. The company’s business plan and expertise has fueled it to serve more than 2,000 medical and payer organizations in 47 states and employs 1,250 associates. He said the company has become a sought-after resource to help solve some of the trickiest and most costly administrative snarls faced by the industry.
“One, we’re providing technology, which is a claims, billing, and processing platform for the federal government. We do that for the VA today,” he said. “We also do a lot of billing, follow up, denial management, and medical coding where we’re actually an extension of our client, helping them to do the work, which ideally optimizes their cash flow.”
Vairo continued, “Thirdly is a consulting piece. We acquired a consulting firm in 2022 and in that role, we are really helping clients to identify where the opportunities are for them to really maximize reimbursement, minimize expense, and optimize systems.”
Commonly, health care clients find themselves foundering under the weight of regulatory pressure, underused yet expensive technology, and rising personnel costs, Vairo said, and Signature Performance takes a turnkey approach toward the most pervasive of these.
“Increased regulation creates more and more administrative burden. That doesn’t mean (regulation is) all bad, but there is a cost or expense required in order to meet them,” he said. “Technology, if used properly, can create significant efficiencies, which ideally over time would reduce that administrative burden. However, what happens, and what we often see, is our client hospitals may not utilize technology to the optimum level. They spend a lot of money for it, but they don’t use all of it.”
The company’s suite of expertise coupled with the expertise of staff―Vairo, who has been in health care for 32 years, is among many other experienced associates across the company who have been hired directly from the medical field or in roles in health care administration―helps Signature devise sound solutions to market challenges.
Signature Performance not only recruits for success, but also actively invests in it. The holder of multiple “Best Places to Work” awards by various local and national entities, the company seeks to empower each employee for personal growth and show them the path to advancement through its Uncommon Leadership Playbook.
“I believe everyone wants to make an impact, everyone wants to make a difference, be successful. I just don’t know too many people that don’t,” founder and CEO Allen Fredrickson said in his address to the 2023 ICAN Conference in Omaha, “but I think people are challenged with how do we become successful? How do you do it?
“So, we created what we call an Uncommon Leadership Playbook. Everyone needs to put their own fingerprints on how they march forward, but we do give them guidelines. In this playbook we have seven or eight key themes, if you will, and then there’re self-tests that they can administer on their own so they can score themselves and how they are doing. They have a sense of what success looks like and how they go about doing it, because they’re drawing upon their own great gifts.”
Now in its 20th year, Signature has expanded from its initial clientele of federal clients, specifically the Department of Defense, performing revenue cycle services for military hospitals across the country and overseas. That work would eventually lead to the Veterans Administration, which helped the company flex its expertise on both the provider and payer sides of the health care revenue equation.
For as large as the company has become, Vairo said he takes the most pride in how the firm serves the smallest and most vulnerable clients, many of whom hit close to home.
“We love to work in the rural markets and the small critical access hospitals,” he said. “Critical access is a designation given to hospitals less than 25 beds that are serving a unique need, primarily in rural America. It’s important that we, as a nation, help those hospitals survive and ideally thrive, because if they have to close down, then people in those communities have to drive much further to receive quality care.
“We also work with the medium and large multi-hospital health care systems, and we enjoy all of that, but we really love serving that rural market. I’ll tell you, there are several that we work with that are thriving and doing well that were going to close their doors if they didn’t get something going. Without Signature, I’m fairly confident they wouldn’t be around today. That really jazzes me up to know that we’ve made that kind of an impact.”
For more information, visit signatureperformance.com.
This article originally appeared in the February/March 2025 issue of B2B Magazine. To receive the magazine, click here to subscribe.