Literature Review

Addus closes $350M Gentiva Personal Care deal Hospice News; by Jim Parker; 12/2/24 Addus HomeCare Corporation (Nasdaq: ADUS) has closed its $350 million acquisition of Gentiva’s personal care business. Gentiva’s personal care segment brings in annual revenues of close to $280.0 million. Post-transaction, Addus will continue with a leverage ratio of less than 3x, with the ability to further that amount with the influx of revenue resulting from this deal, Addus Chairman and CEO Dirk Allision said in a statement. ... Addus provides personal care, home health and hospice to more than 48,500 patients across 22 states. Its total revenue reached $289.8 million in the Q3 of 2024, a 7% year-over-year increase. Its personal care revenues reached $215.4 million that period.

705 hospitals at risk of closure, state by stateBecker's Hospital CFO Report; by Molly Gamble; 11/22/24 More than 700 rural U.S. hospitals are at risk of closure due to financial problems, with more than half of those hospitals at immediate risk of closure. The count comes from the latest analysis from the Center for Healthcare Quality and Payment Reform, which is based on CMS's October 2024 hospital financial information. The center's analysis reveals two distinct levels of vulnerability among rural healthcare facilities: risk of closure and immediate risk of closure. ... The report also analyzes hospitals facing immediate threat of closure meaning financial reserves could offset losses on patient services for two to three years at most. Currently, 364 rural hospitals are at immediate risk of shutting down due to severe financial difficulties. [Click on the title's link for] a state-by-state listing of the number of rural hospitals at risk of closure in the next six to seven years and at immediate risk of closure over the next two to three years. Editor's note: Consider how these closures impact patients' trajectories of serious illness, timely treatment plans, referrals to home health, nursing facilities, and hospice care. How do these impact your service areas? What are the root causes for so many potential closures?

40 largest health systems in the US | 2024 Becker's Hospital Review; by Laura Dyrda; 11/27/24 Some large health systems grew while others shrunk over the last year, and more consolidation could be ahead. But changes were minimal in either direction, and the largest health systems this year remain relatively similar to previous years. Becker's compiled a list of the largest health systems in the U.S. based on the number of hospitals reported on the system's website. ... Note: The list below is not a ranking. Data includes all hospitals within the system. [Click on the title's link for the full list of 40 health systems.]

NUMC partners with Hospice of New York to offer hospice servicesLong Island Press; 11/27/24 The Nassau Health Care Corporation, which represents Nassau University Medical Center, and the A. Holly Patterson Extended Care Facility have announced a partnership with Hospice of New York to offer hospice services for the first time for patients, regardless of their ability to pay. ... Megan C. Ryan, NHCC interim president and CEO [said,] “Hospice of New York’s proven expertise ensures that this initiative will provide the highest standard of care to patients and their families, including those from low-income and at-risk populations. Bringing this kind of care to those at their most vulnerable is why NUMC exists and why this partnership is so groundbreaking for both our institution and Hospice. We welcome the Hospice team to the NUMC family.” Ryan announced the appointment of Simon Ulubabov to the recently-created position of executive vice president for Hospital and Palliative Care Services at NUMC. 

Valley Health and Hospice of the Panhandle collaborate to expand hospice care Global Data; 11/26/24 Valley Health has partnered with Hospice of the Panhandle to launch a hospice care programme within its hospitals, War Memorial Hospital (WarMH) in Berkeley Springs and Hampshire Memorial Hospital (HMH) in Romney, West Virginia, US. An agreement, effective from 1 November, integrates Hospice of the Panhandle with the hospitals' existing care teams, aiming to enhance the quality and accessibility of end-of-life care for eligible patients and their families.  The Hospice in the Hospital programme, which began in 2020 at Winchester Medical Centre, has now extended to all Valley Health hospitals in Virginia and, with this recent development, to West Virginia. HMH and WarMH operations vice president Heather Sigel said: “We are extremely thankful to the Hospice of the Panhandle team for partnering with us to offer Hospice in the Hospital at both War Memorial and Hampshire Memorial. ..."

Why the DOJ’s lawsuit against the UGH-Amedisys merger may not go anywhere MedCityNews; by Marissa Plescia; 11/21/24 Experts aren’t sure what the outcome of the DOJ’s recent lawsuit against the proposed UnitedHealth Group/Amedisys merger will be under the incoming Trump administration. The Biden administration has focused more on supporting clinicians, while the previous Trump administration favored corporations. ...  But even aside from the differences in governing philosophy, one expert noted that the main reason for antitrust lawsuits — prices would rise as a result of the transaction, hurting consumers and patients — seems to be missing from the equation here. That’s because of the outsized role Medicare and Medicaid play in the home health industry. ... By acquiring Amedisys, UHG would grow its home health and hospice footprint to five more states, as well as receive 500 additional locations across 32 states it already operates in. The deal would also give UHG control of at least 30% of the home health or hospice services in eight states. ... Will the DOJ succeed? It's hard to say for sure what the outcome of the DOJ’s lawsuit will be, particularly with the change in administration. ... 

YoloCares: The case for independenceThe Davis Enterprise; by Craig Dresang; 11/17/24I recently received an email from an individual in Temple Terrace, Fla., informing me that two Northern California nonprofit hospices — with close historical ties to YoloCares — have decided, via affiliation, to turn their keys over to a Florida-based health system that has had no previous presence in California.Publisher's note: Craig Dresang, CEO of YoloCares, goes on to discuss questions and concerns with Chapters Health System's (Tampa, FL) acquisition of Hospice of East Bay (Pleasant Hill, CA), Hospice of Santa Cruz County (Scotts Valley, CA), Nathan Adelson Hospice (Las Vegas, NV), and Willamette Vital Health (Salem, OR). The original story - Chapters Health System launches new Chapters Health West Division - was announced 10/30/24.

Pursuit of quick profits makes hospice care worse, new research says Ohio Capital Journal; by Marty Schladen; 11/20/24 Private equity firms — high-dollar investors known for aggressively seeking profit — and publicly traded health conglomerates have been buying up businesses that provide hospice care. But when it comes to caring for patients facing the end of their lives, those businesses perform worst, according to a research letter published Monday in the Journal of the American Medical Association. ...  Publicly traded behemoths such as UnitedHealth Group and CVS Health are already the subject of investigations and lawsuits by federal and state government over allegedly anticompetitive actions as drug middlemen. At the same time, both provide hospice care. Meanwhile, the business practices of private equity groups have been coming under increasing scrutiny over the past decade. They often buy businesses in deals structured so they can quickly recoup their investment, identify the most profitable assets, sell them and then sell the resulting business or declare bankruptcy. ... The firms also have been accused of being predatory toward consumers.

Hospice of Santa Cruz County enters regional partnership ahead of coming reimbursement model changes Modesto Bee, Scotts Valley, CA; by PK Hattis; 11/16/24 The health care landscape has changed a lot in the past 42 years, but for hospice care providers, some things have remained remarkably consistent. ... But that reimbursement process is about to be upended in only a few years and it has caused a handful of hospice providers, including a branch in Santa Cruz County, to form a regional partnership in hopes of ensuring the unique health care service endures for decades to come. Hospice of Santa Cruz County, founded in 1978 when the hospice movement was in its infancy, announced it has locked arms with four other nonprofit hospices and health care organizations to form Chapters Health West - a coalition that will allow the organizations to pool resources ahead of an era of reimbursement model upheaval. "We've been here for 47 years; we want to be here for another 47 years," Hospice of Santa Cruz County CEO Cathy Conway told the Sentinel in recent interview from her office in Scotts Valley. "What got us here for the last 47 won't get us to the next 47 because these changes are happening."

Kaiser keeps cutting costs to stem operating losses Modern Healthcare; by Caroline Hudson; 11/8/24 Kaiser Permanente has continued implementing cost-cutting measures in an attempt to quell losses stemming in part from high medical expenses. ... Oakland, California-based Kaiser reported a $608 million operating loss in the third quarter, compared with a $156 million gain in the year-ago period. Net income was $845 million in the third quarter, compared with $239 million a year ago. CEO Greg Adams said in a news release he remains confident in Kaiser's integrated model and thinks it helps the health system navigate changes in the operating environment. Kaiser reported a $13 million gain in the quarter related to the Geisinger Health acquisition earlier this year. Kaiser Foundation Hospitals acquired Geisinger in April and folded it into Risant Health, a new nonprofit formed to create a national value-based care network. Washington, D.C.-based Risant is tasked with acquiring a handful of other systems to add to the network. In June, Risant announced plans to buy Cone Health in Greensboro, North Carolina, as part of a deal expected to close next year.

DOJ preps lawsuit to block UnitedHealth-Amedisys deal Modern Healthcare; by Josh Sisco, Bloomberg; 11/12/24 The US Justice Department is moving to block UnitedHealth Group Inc.’s $3.3 billion purchase of Amedisys Inc. over concerns the deal would harm competition in the market for home-health services, according to people familiar with the matter.  Justice Department antitrust officials have signed off on a lawsuit to be filed in federal court as soon as this week to stop the deal, according to the people, who asked not to be named discussing a nonpublic matter. The move follows a meeting last week between company executives and the Justice Department in a last-ditch effort to ease the government’s concerns, the people said. 

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.