Literature Review

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.”

Amedisys is now oversold (AMED) Nasdaq; by BNK Invest; 10/31/24 Legendary investor Warren Buffett advises to be fearful when others are greedy, and be greedy when others are fearful. One way we can try to measure the level of fear in a given stock is through a technical analysis indicator called the Relative Strength Index, or RSI, which measures momentum on a scale of zero to 100. A stock is considered to be oversold if the RSI reading falls below 30. In trading on Thursday [10/31], shares of Amedisys, Inc. (Symbol: AMED) entered into oversold territory, hitting an RSI reading of 29.4, after changing hands as low as $94.76 per share. By comparison, the current RSI reading of the S&P 500 ETF (SPY) is 44.0. ...

Hands On Medicine says goodbye as independent clinics struggle to break even The Lund Report; by Jake Thomas; 10/29/24  After 18 years of operating her northeast Portland primary care clinic, Shelda Holmes decided it would be better to close Hands on Medicine than prop up what she calls the “medical industrial health complex.” Her story shows the predicament faced by independent primary care clinics, and sheds light on why so many are shutting down or selling out to hospital systems or private equity owned chains — even passionate, devoted providers like Holmes. “You hear the anthem: ‘We need more primary care providers,’” Holmes, a nurse practitioner, told The Lund Report. “You feel it in your heart. But the obstacles are nearly unsurmountable. We can’t answer the call.” Research shows that robust primary care can reduce health care spending by treating patients' medical problems before they become more expensive. Holmes’ story spotlights what critics say are worrying trends that are eroding providers’ independence and clinical decision-making while increasingly putting primary care —a service that policymakers want more of — out of reach. 

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." 

Large systems outsource home care to focus on 'core business' Becker's Hospital CFO Report; by Alan Condon; 10/25/24 A growing number of health systems are outsourcing home health and hospice operations to third-party specialists with broader geographic reach to reduce cost and administrative burdens and focus on core services. The regulatory environment for home health and hospice is complex, with stringent requirements for reimbursement, reporting and patient care standards. Partnering with an outsourced provider also helps systems mitigate the risks associated with non-compliance and operational issues. Here are four health systems that have outsourced or plan to outsource home health and hospicare care:

New FTC regulations could create obstacles for hospice M&A Hospice News; by Jim Parker; 10/24/24 Changes to federal rules governing mergers and acquisitions could have sweeping effects on hospice and other health care transactions. The Federal Trade Commission (FTC) recently finalized a rule that will implement changes to required pre-merger notification forms. Pursuant to the Hart-Scott-Rodino Act, parties to certain transactions must submit these documents to the FTC and other regulatory agencies to help identify and address potential antitrust concerns. The law requires that transactions exceeding $120 million must submit the form, which agencies will use to conduct a 30-day premerger assessment, according to Luke Smith, member at the law firm Bass, Berry and Sims. The final rule will likely complicate the closing of some hospice acquisitions.

Duke Health CFOs' plan to reach 1 in 4 North Carolinians Becker's Hospital CFO Report; by Madeline Ashley; 10/21/24 Since Lisa Goodlett was named senior vice president, CFO and treasurer of Durham, N.C.-based Duke University Health System in March, one of the health system's main goals has been to increase access to the health system from 8% of North Carolina's population to more than 25%. To achieve this, the health system is leveraging technology and looking at expanding partnerships to ensure services are more widely available. ... As Duke Health continues to push expanded care access, the health system has also been in contract negotiations with UnitedHealthcare for the last few weeks regarding 172,000 of its patients.  ... If the parties cannot come to an agreement by Nov. 1, Duke Health's hospitals, facilities and physicians would be out of network for employer-sponsored commercial plans, including UMR and Medicare Advantage plans, including a group retiree and dual special-needs plans.

Providence, Compassus form home care joint ventureModern Healthcare; by Diane Eastabrook; 10/22/24Home care provider Compassus will take over management of Providence’s home-based care services through a joint venture the two companies announced Tuesday. Under the arrangement, Brentwood, Texas-based Compassus would manage and jointly own Providence’s home health, hospice, community-based palliative care and private duty nursing services under the name Providence at Home with Compassus, the companies said in a news release. Neither company would disclose financial terms of the deal, which is subject to approval by state and federal regulators.Publisher's note: This joint venture is different from other recent Compassus joint ventures with Mercy Health, OhioHealth, and Bon Secours.

Martis Capital rumored to purchase Three Oaks Hospice’s in $150m deal Hospice News; by Holly Vossel; 10/18/24 The private equity firm Martis Capital may soon acquire Dallas-based Three Oaks Hospice for a price tag ranging from $150 million to $160 million. Rumors of the potential sale appeared today in an Axios report, in which unnamed sources reportedly confirmed the deal. The Nashville-based investment and management company Petra Capital currently owns Three Oaks Hospice, which reportedly generates between $10 and $13 million in EBITDA, Axios indicated. Rumors that the hospice was considering a potential sale were first reported last month by the website Ion Analytics. The private-equity backed company provides hospice, palliative care and bereavement services across 28 locations in seven states. 

How physicians can navigate ethical conflicts when caring for patients Physician's Weekly; 10/14/24 ... According to the president of The Physicians Foundation, Gary Price, MD, ethics in medical care are particularly complicated regarding end-of-life choices. While decades ago, a patient’s primary care provider (PCP) would have been involved in that patient’s hospitalized care and their end-of-life decisions within the hospital, the fragmented nature of today’s healthcare system has all but eliminated PCPs from involvement in hospitalized patient care. As such, patients often make end-of-life decisions based on the guidance of doctors with whom they have no pre-existing relationship. Other factors that blur ethical lines in healthcare, adds Dr. Price, are the new state of healthcare ownership and financing. Dr. Price mentions, for instance, conflicts of interest due to the US’s biggest employer of physicians, Optum, being a subsidiary of the same company that owns UnitedHealthcare. This situation allows for an insurer who controls reimbursement and who could, as the physician’s employer, influence decisions made regarding patient care. Sadly, this influence largely comes from financial concern instead of concern for the patient’s best health outcomes. 

MD Home Health expands services with in-clinic, virtual care, remote patient monitoring, house calls and hospice Longview News-Journal, Phoenix, AZ; by MD Home Health; 10/15/24 Leading Home Health Agency in Arizona launches comprehensive onmnichannel healthcare approach. MD Home Health, a privately-held leading Arizona-based home health agency, today announced the expansion of its healthcare services to include in-clinic care, virtual care, remote patient monitoring, house calls, and hospice, making it one of the first privately-held home health agencies in Arizona to offer a full and comprehensive omnichannel healthcare approach. This expansion allows the firm to broaden its healthcare offering to significantly increase access to comprehensive, quality and convenient healthcare for residents across the Phoenix metro area. "Our new and comprehensive services are designed to ensure that patients have convenient and flexible options to access quality healthcare how, when and where they need it," said David P. Tusa, President and Chief Executive Officer of MD Home Health.