Literature Review

St. Francis Reflections and Treasure Health finalize partnership Cision PRWeb, Stuart, FL; Press Release by Treasure Coast Hospice; 10/7/24 Space Coast-based St. Francis Reflections Lifestage Care and Treasure Coast-based Treasure Health announced today that the two organizations have finalized their partnership agreement. Together, the two non-profit hospice and palliative care providers serve more than 7,000 patients annually and employ more than 600 clinical and administrative staff in Brevard, Martin, St. Lucie and Okeechobee counties. Since announcing their intent to partner last year, St. Francis Reflections and Treasure Health, and its flagship program Treasure Coast Hospice, have been working collaboratively to align their shared mission of providing compassionate end-of-life care to patients and families in their respective communities. [Click the title's link for statements from St. Francis Reflections President and CEO Joseph Killian, CHPCA and Treasure Health President and CEO Jackie Kendrick, CHPCA.]

Inside palliative care at Contessa’s Health System joint ventures Hospice News; by Jim Parker; 9/27/24 Contessa, the innovation and high-acuity arm of Amedisys Inc. has made large investments in expanding access to palliative care, particularly through joint ventures with health systems. Amedisys acquired Contessa in 2021 for $250 million. The subsidiary’s specialty is high-acuity care in the home, including hospital-at-home and skilled nursing facility-at-home programs, but in recent years it has also leaned hard into growing its palliative care business. For now, Amedisys shows no signs of slowing down on palliative care. Expanding palliative care relationships and joint venture partnerships is a priority for 2024, the Louisiana-based home health and hospice provider indicated in a filing with the U.S. Securities and Exchange Commission (SEC) earlier this year. 

16 large health systems growing bigger Becker's Hospital Review; by Alan Condon; 9/20/24 Merger and acquisition activity is rebounding after a drop in deal volume during the pandemic, with many large health systems growing their hospital portfolios or planning to add more hospitals in the coming quarters. Sixteen health systems growing bigger: ... This is not an exhaustive list.

2 years after its rebrand, CenterWell Home Health is set on tackling big goals Home Health Care News; by Andrew Donlan; 9/24/24 Kirk Allen, the president of home solutions at Humana Inc., is living a home health veteran’s dream. Right now, he is heads down on helping create a value-based home health model within CenterWell, Humana’s provider services arm. Home health leaders have always touted the extraordinary health and monetary value that can be derived from their services. Not many have had the opportunity to prove that out, however. Allen does. Humana owns CenterWell Home Health, which is one of the largest providers in the country. CenterWell also includes CenterWell Pharmacy and CenterWell Primary Care. Eventually, CenterWell Home Health wants to have 80,000 home health patients under its value-based model. ... After Humana fully acquired Kindred at Home, it divested the home care and hospice assets. With the large and remaining home health footprint, Humana created CenterWell Home Health.

Why CenterWell is moving into Walmart Becker's Payer Issues; by Rylee Wilson; 9/17/24 Primary care clinics focusing mainly on older adults are more likely to serve Black patients and those dually eligible for Medicare and Medicaid, a study from Humana found.  The study, published in Health Affairs in September, studied the outcomes of older adult-focused primary care organizations and found the organizations tend to enter and serve historically more disadvantaged communities. The authors defined such organizations as reimbursed predominantly through population-based payment arrangements and serving mostly older adults with Medicare. Humana's CenterWell is one such organization, alongside Oak Street Health and One Medical Seniors. CenterWell is expanding, with plans to enter three new markets in 2024. The company aims to add 30 to 50 new centers per year through 2025 and will also open clinics at 23 former Walmart Health sites.

How the Fed’s interest rate cuts could affect hospice M&A Hospice News; by Jim Parker; 9/19/24 The Federal Reserve cut interest rates by 0.5% on Wednesday, which will likely have an impact on hospice M&A. Interest rates have widespread implications for the hospice mergers and acquisitions market, particularly when it comes to private equity investments. PE firms, and some publicly traded companies, tend to finance their acquisitions by taking on debt. The rate reduction — from close to 5.5% to between 5% and 4.75% — means that the flow of dollars may pick up as borrowing gets less expensive. The slash in interest rates could result in a resurgence of M&A in the hospice space through the end of the year and into 2025, according to Cory Mertz, managing partner at M&A advisory firm Mertz Taggart. ...

Three Oaks Hospice reportedly begins sales process Hospice News; by Jim Parker; 9/16/24 Dallas-based Three Oaks Hospice has reportedly begun seeking a buyer. The private equity-backed hospice launched in 2019 with more than $21 million in investment dollars from Granite Growth Health Partners, Health Velocity Capital and Petra Capital Partners. Rumors of the potential sale were first reported by the website Ion Analytics, which indicated that Three Oaks generates between $12 million and $15 million EBITDA.

Crossroads Hospice & Palliative Care is primed for continued success 9/13/24; Business Wire - Crossroads Hospice & Palliative Care; by Lisa Simon; 9/13/24 Crossroads Hospice & Palliative Care, the leading end-of-life care company, is affirming its commitment to growing its four Ohio locations in Cleveland, Northeast Ohio, Cincinnati and Dayton along with two others, one outside Philadelphia, Pennsylvania and one in Memphis, Tennessee. “We are committed to building our remaining locations and we have the depth of talent and proven standards for the highest quality care and the most time spent bedside, including attended deaths, compared with any other hospice. This is an opportunity for Crossroads to reach its highest potential.” That’s after selling five locations in Missouri, Kansas, Oklahoma and Georgia to Spartanburg, SC-headquartered Agape Care Group, a portfolio company of Ridgemont Equity Partners, earlier this week. Crossroads had been considering a strategic sale of some locations for a number of reasons. Now company leaders are viewing the future of the 29-year-old leader in hospice and palliative care with enthusiasm as they become a more streamlined company with a smaller geographic footprint. “The potential for innovation has never been higher,” said Crossroads CEO and Co-Founder Perry Farmer. “We are committed to building our remaining locations and we have the depth of talent and proven standards for the highest quality care and the most time spent bedside, including attended deaths, compared with any other hospice." ... COO and Co-Founder Clayton Farmer agreed while acknowledging how entrenched Crossroads is in the markets where it operates. “We want our valued referral partners in Ohio, Pennsylvania and Tennessee to know we are here to continue serving their patients and families and we will strive to continue to beat all national averages on key hospice industry metrics.” 

Private equity acquisition of physician practices — Looking for ethical guidance from professional societiesJAMA Network; by Peter A. Ubel; 9/13/24In 2012, private equity firms purchased approximately 75 physician-owned practices; by 2021, that number had risen to almost 500. Most commonly, firms have sought high-paid subspecialty practices. For example, dermatologists make up approximately 1% of physicians in the US, whereas dermatology practices account for 15% of private equity acquisitions. Private equity firms can offer valuable administrative support to clinical practices. Some firms offer expertise to help practices respond to rapidly changing regulatory and reimbursement environments. Firms also provide financial rewards to clinicians who have often spent decades building successful practices. However, private equity acquisitions can also lead to ethically troubling consequences. For example, to maximize the return on their investments, private equity firms sometimes pressure clinicians to see more patients, perform more procedures on those patients, and upsell patients on products not reimbursed by insurance, such as acne creams stocked in dermatology offices. In addition, after being acquired by firms, medical practices often raise medical prices, including an increase in out-of-network billing and surprise bills. These price increases harm patients by increasing their out-of-pocket expenses and, potentially, reducing their ability to pay for care, thus contributing to financial nonadherence and medical debt... In short, some professional societies offer guidance on how to promote members’ interests when selling to private equity, even reminding them to factor the value of their real estate into the sale price, but they offer scant information on the ethical tradeoffs created by such sales.

Antitrust lessons for healthcare roll-ups – and everyone else Competition Policy International - CPI Columns US & Canada; by Lauren F. Dayton & Swara Saraiya; 9/12/24 ... The practice described in the U.S. Anesthesia Partners suit, known as a “roll-up,” is a common strategy employed by private equity firms through which smaller businesses in adjacent markets are acquired and consolidated. Large healthcare networks acquire smaller practices for similar reasons. That consolidation enables companies to build a greater presence, operate more efficiently, and can allow them to attract better talent. But that same consolidation can also create the risk of anticompetitive effects. The FTC’s suit is noteworthy because federal competition regulators have historically focused on the companies themselves, not their financial sponsors. The case is in step with statements by competition regulators about increased scrutiny of the healthcare industry, and of acquisitions by private equity firms, in particular. ...

More nonprofit hospices consolidating amid economic, regulatory pressures Hospice News; by Jim Parker; 9/12/24 As M&A in the for-profit space continues its two-year slump, nonprofits are consolidating in rising numbers. Recent years have seen an uptick in consolidation activity among nonprofits in the hospice space. Increasingly, nonprofits are pursuing acquisitions and affiliations, as well as forming regional collaboratives. In addition, some nonprofits have also been acquired by for-profit companies. Driving this trend are reimbursement and regulatory pressures, as well as a need to compete with larger, well-capitalized for-profit entities, according to Mark Kulik, senior managing director for the M&A advisory firm The Braff Group. [Click on the title's link to continue reading this significant article.] 

Leading the Way: Gilchrist and Franklin Hospice forces in landmark integration Franklin Hospice, Chambersburg, PA; by Karen M. Giffin; 9/9/24 Franklin Hospice and Gilchrist ... have announced an affiliation agreement. This partnership will unite two of Maryland’s oldest and most experienced nonprofit organizations, together with nearly 70 years of service to their communities. As the healthcare landscape continues to transform nationwide, this type of affiliation of two synergistic nonprofit organizations with similar missions, visions, and values will position both organizations for continued growth, innovation and financial strength. ... This strategic affiliation will strengthen their ability to offer compassionate care to more patients and families throughout Central and Southern Maryland, as well as Washington and Frederick Counties and South-Central Pennsylvania. Both organizations will retain their name and branding while offering a unified approach to care. 

BrightSpring projects ‘robust, cccretive’ hospice, home health M&A pipeline Hospice News; by Holly Vossel; 9/6/24 BrightSpring Health Services Inc. is poised for growth in the home health and hospice landscape. The company anticipates ramping up merger and acquisition (M&A) activity in coming years, with an emphasis on long-term return on investment, according to BrightSpring President and CEO Jon Rousseau. The company is focusing on significant expansion in the next two years, he indicated. Tuck-in deals and de novos have been key to BrightSpring’s strategic growth. Acquisitions have increasingly become a larger part of its game plan — though with a cautious and diligent mindset, Rousseau said ...