Literature Review

‘Everything is lining up’: Home-based care M&A expected to soar in near-term future Home Health News; by Audrie Martin; 11/11/24 Home health, home care and hospice M&A was historically high in 2021, with high valuations serving sellers and solid return on investment serving buyers. Transactions plummeted after that, but recent signs suggest M&A is beginning to pick back up across sectors. ... Sellers should expect questions about employee retention, the company’s track record of growth after M&A and whether their leadership has done due diligence before entering the race. ... Experts predict that large, founder-led home health and hospice businesses will be in high demand in the coming year. Larger home care companies, especially those that are Medicaid-funded, will also be in demand. 

Cigna ends Humana merger talks, prioritizes share buybacks Modern Healthcare - Insurance; by John Lauerman, Bloomberg; 11/11/24 Cigna Group said it won’t pursue a combination with rival insurer Humana Inc. after reports the two companies had renewed discussions of a deal. The company “remains committed to its established M&A criteria and would only consider acquisitions that are strategically aligned, financially attractive, and have a high probability to close,” according to a statement Monday. Cigna shares jumped by 8% in premarket trading, while shares in Humana dropped by 7%. The two health insurance giants, with a combined market value of roughly $125 billion, held talks about a deal last year, but Cigna walked away after the two companies failed to agree on a price, Bloomberg News reported in December.   

Eden Health acquires A Plus Hospice Care Hospice News; by Jim Parker; 11/11/24 Eden Health of Northern Nevada, dba Eden Hospice, has acquired A Plus Hospice Care in its home state. Financial terms were undisclosed. Through the transaction, A Plus Hospice Care patients will have access to Eden Health’s additional services, including home health, home care and palliative care. The M&A advisory firm Agenda Health consulted on the deal. Cultural alignment, proximity to its existing footprint and the seller’s strong track record on compliance were factors in Eden’s decision to acquire, Jamie Brown, the company’s COO, told Hospice News in an email. ... Eden Health is a 100% employee-owned company operating in Washington state, Nevada, California, Idaho, Montana, Wyoming and Arizona.

Aveanna revs hospice, home health M&A engine Hospice News; by Holly Vossel; 11/7/24 Aveanna Healthcare Holdings (Nasdaq: AVAH) is ramping up its merger and acquisition activity in the home health and hospice space heading into next year. The Atlanta-headquartered company has set its strategic sights on both private duty nursing and hospice and home health, according to Aveanna CEO Jeff Shaner. The company has been quiet on the M&A front in recent years, taking a cautious approach to growth, Shaner said during an earnings call on Thursday. Aveanna is in the process of reviewing a few potential acquisitions, which could close in 2025, he indicated.

Payers push into home health: 5 things to know Becker's Payer Issues; by Rylee Wilson; 11/4/24 Payers are expanding their reach into home healthcare. In October, Elevance Health said it plans to acquire CareBridge, a Nashville-based home and community care provider. Elevance will pay $2.7 billion for the company, according to the Nashville Business Journal. Elevance CEO Gail Boudreaux told investors on an Oct. 17 call the acquisition will serve as the foundation for Carelon's home health business. Here are five more things to know about payers' ventures into home health:

Choice Health at Home announces new credit facilities and the strategic acquisition of Accentra Home Health and Hospice News Channel Nebraska Southeast; Press Release; 11/6/24 Choice Health at Home (“Choice”), a leading multi-state operator of home health, hospice, private duty, and rehabilitation services providing care throughout the Southwestern US, is proud to announce the company’s most recent acquisition and newly expanded credit facilities for the future growth of the organization. On the transaction front, Choice announced its acquisition of Accentra Home Health and Hospice (“Accentra”), a multi-agency home health and hospice organization in the state of Oklahoma. The merger of Accentra with Choice’s already significant existing Oklahoma home health and hospice agencies will dramatically strengthen the company’s presence in Oklahoma and provide the infrastructure for a long-term strategic plan to cover more than 90% of the state’s urban and rural geographies.

Elevance is latest to invest in home health with Carebridge acquisition HealthLeaders; by Jay Asser; 11/4/24 The home-based care business is seeing increased interest and could be ripe for more activity going forward. Key Takeaways: 

BrightSpring CEO: Home health, hospice acquisitions offer ‘high return on investment’ Home Health Care News; by Audrie Martin; 11/1/24 The newest home-based care face on the public market, BrightSpring Health Services (Nasdaq: BTSG), is making strides. The company announced a successful third quarter during its earnings call Friday. Leaders reported an overall increase in business and raised 2024 revenue and adjusted EBITDA guidance. Provider service segment revenue grew across service lines for the Louisville, Kentucky-based company. This was primarily attributed to billable hours growth and its Rehab in Motion program supporting Medicare Part B outpatient rehab patients. ... “From an acquisition strategy perspective, I think it’s going to be consistent with what we’ve done over the past couple of years,” he said. “On the provider side, it’s been rehab, home health and hospice, and then home-based primary care as well. We currently have three or four very small tuck-ins for home health and hospice, which are high returns on investment. On the de novo side, it’s really on home health, hospice and rehab.”

CareTrust, JV partner to acquire 31 skilled nursing facilities in $500 million deal Skilled Nursing News; by Tim Mullaney; 10/29/24 CareTrust REIT (NYSE: CTRE) and a joint venture partner have reached an agreement to acquire a portfolio of 31 skilled nursing facilities for approximately $500 million, the company’s largest acquisition to date. San Clemente, California-based CareTrust anticipates that most of the facilities will be operated by existing partners of the REIT, including The Ensign Group (Nasdaq: ENSG), PACS Group (NYSE: PACS) and Links Healthcare Group, the company announced Tuesday. The portfolio being acquired totals 3,290 licensed beds, with 30 of the locations in Tennessee and one in Alabama. CareTrust anticipates that the deal will close in the fourth quarter of 2024. ... PACS will be adding 12 of the 31 properties to its ranks, all 12 are in Tennessee; PACS currently operates 276 post-acute care and senior living facilities across 15 states. This is a new state for the Utah-based operator. PACS may purchase the real estate on six of the facilities between years four and seven of the lease with CareTrust, PACS said in a statement.

Chapters Health System launches new Chapters Health West DivisionCision PRWeb; by Chapters Health System; 10/30/24 Chapters Health System, in collaboration with four highly respected not-for-profit organizations — Hospice East Bay (Pleasant Hill, CA), Hospice of Santa Cruz County (Santa Cruz, CA), Nathan Adelson Hospice (Las Vegas, NV) and Willamette Vital Health (Salem, OR) — is proud to announce the creation and official launch of Chapters Health West. This landmark partnership signifies the beginning of a new era in not-for-profit hospice care across the Western United States, blending innovation with a commitment to compassionate, community-based care. "We are building a future where we can do more, innovate more and serve more," said Andrew Molosky, MBA, CHPCA, president and chief executive officer for Chapters Health. "By aligning our strengths, we will continue to deliver exceptional care while expanding our capacity to meet the growing needs of those navigating serious illness and grief in our communities." 

UnitedHealth Group, Amedisys to meet with Justice Department to push for acquisition’s closure Hospice News; by Jim Parker; 10/26/24 Executives from UnitedHealth Group and Amedisys reportedly will meet with U.S. Justice Department officials in an effort to seal their pending deal. Amedisys has indicated that it expects the deal to close in Q4. However, the Justice Department (DOJ) has been making inquiries into the transaction and reportedly has been considering a lawsuit to block it, due to potential antitrust concerns. To date, neither Amedisys nor UnitedHealth Group have been accused of any wrongdoing. Bloomberg first reported on the DOJ meeting, which might begin on Monday, according to sources “familiar with the matter.” The meeting will include Jonathan Kanter, assistant attorney general for the DOJ’s Antitrust Division, Bloomberg reported.

Help at Home to acquire Helpmates, Inc. The Daily Herald, Huntingdon, PA; 10/21/24 Penn Highlands Healthcare and Excel Companion Care, LLC, doing business as Help at Home, have agreed to the acquisition of Helpmates, Inc., the health system’s non-skilled in-home services. Help at Home is a national in-home provider with a focus on unskilled personal care services. “The acquisition of Helpmates enables our health system to focus and grow the core services of Healthcare at Home which include home health and hospice,” said Cheryl Mitchell, Service Line Leader of Penn Highlands Healthcare at Home. ... The acquisition will occur on or around December 9, 2024 following governmental approval. 

Cigna resumes merger discussions with HumanaModern Healthcare; by Michelle F. Davis, John Tozzi; 10/18/24Cigna Group has revived efforts to combine with its smaller rival Humana Inc. after merger talks fell apart late last year, according to people familiar with the matter... The discussions are in early stages, they added.