Literature Review

Hospice a cornerstone of New Day’s 3-pronged growth strategy Hospice News; Holly Vossel; 11/20/24 New Day Healthcare LLC is prioritizing hospice growth in its strategic plans as the home-based care company focuses on improving quality for patients across the care continuum. Texas-based New Day launched in 2020 by a group of former hospice and home health professionals. The organization offers hospice, home health and personal care through several brands. New Day’s three-pronged merger and acquisition approach hinges on culture, quality and clinical excellence, according to CEO and Founder G. Scott Herman. Quality is perhaps the most important driver in a transaction consideration, Herman stated. ... To date, New Day has integrated 11 acquisitions into its pipeline, four of which have involved hospice assets.

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.

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.”

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. ...