Literature Review

Hospital mergers and health care price increases: A primer for reporters Association of Health Care Journalists (AHCG); by AHCG Staff; 9/24/24 Hospital mergers — market consolidation — can lead to health care price increases of anywhere from 3% to 65%, according to a 2022 RAND Corporation review. The FTC’s director of the Bureau of Economics has said hospitals that merge may charge 40% to 50% more than if they hadn’t merged. Mergers can also result in layoffs and lower tax revenues and have a negative impact on patient care by reducing access to some health care services. With so much research confirming negative effects and as health care prices continue to rise, what — if anything — can be done to slow market consolidation and/or reduce the harms to patients and local economies?

Hospice provider relocates to Bethlehem [PA] Lehigh Valley Business; by Stacy Wescoe; 9/23/24 Advantage, a provider of contract therapy, home health, and hospice services in Pennsylvania has opened a new office in Bethlehem on the Holy Family Manor campus. The existing Advantage campuses of Emmaus and Old Forge will be relocated to the Advantage Home Health and Hospice Bethlehem office.  Clinical, social, and bereavement services will remain uninterrupted, the company said in a press release, and it will continue to serve all the same areas. 

Ascension posts $1.8B annual loss; liquidity 'remains strong,' CFO says Becker's Hospital CFO Report; by Alan Condon; 9/18/24 St.Louis-based Ascension reported a $79 million operating loss (-0.3% margin) for the 10 months ending April 30, a substantial improvement on the $1.2 billion operating loss in the previous 10-month period. The results include $402 million in one-time, non-cash write-downs and non-recurring losses. In May and June 2024, operations were hampered by the May ransomware attack, resulting in reduced revenues from the associated business interruption along with costs incurred to address the issues and other business-related expenses. Despite this incident, Ascension drove a $1.2 billion operational improvement year over year for the 10 months ending April 30. The 136-hospital system's economic improvement plans focused on volume growth, rates and pricing, and cost levers. 

State scrutiny pf UnitedHealth Group-Amedisys deal pushes timeline back further Home Health Care News; by Audrie Martin; 9/19/24 UnitedHealth Group’s acquisition of Amedisys is still pending. That could be due to a variety of factors, but one is clear: the Oregon Health Authority’s (OHA) ongoing review, which is expected to continue until at least the end of November. OHA’s Health Care Market Oversight (HCMO) program reviews health care business deals to ensure they do not harm the state’s citizens or communities. In July, both UnitedHealth Group and Amedisys submitted responses to the OHA’s request for information. The authority is still seeking public comments on this matter. In addition to the issue in Oregon, the deal has faced scrutiny from federal antitrust regulators, including the U.S. Department of Justice (DOJ).

Private Equity's impact on hospice care: The good, the bad, and the ugly of private equity TCN Talks - Teleios Collaborative Network; by Chris Comeaux; 9/18/24 In this episode, Private Equity's Impact on Hospice Care, The Good, the Bad, and Ugly of Private Equity, Chris interviews Laura Katz Olson, a professor of political science at Lehigh University.  It’s a fascinating discussion based on Laura’s book Ethically Challenged. During their conversation, they delve into the impact of private equity in the healthcare industry.  Private equity firms prioritize making oversized profits and have a short-term focus, often selling companies within six years, relying heavily on debt financing and putting the burden of servicing the debt on the acquired companies.  Leaving a company worse than when the started is the opposite of what leadership is supposed to do for any organization, especially one with such a critical mission. Editor's note: TCN /  Teleios Collaborative Network sponsors our newsletter. 

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.” 

Destin welcomes its first inpatient hospice care center: Vitas suites destination health and rehabilitation South Florida Hospital News, Destin, FL; by cfelixcpa; 9/13/24 Patients nearing the end of life who reside in Okaloosa and Walton counties now have access to inpatient hospice care at the VITAS Suites at Destination Health and Rehabilitation in Destin, Florida. This is the first and only inpatient unit for hospice patients in the two-county region. The nation’s leading provider of end-of-life care celebrated the grand opening of the new suites and is now accepting hospice-eligible patient referrals. ... “The new suites help VITAS further serve the greater community of Pensacola, filling a vital need for acute symptom management for end-of-life patients in the area,” said VITAS General Manager Chasity Tedford. 

Bayada Home Health Care settled nurses’ wages class action lawsuit for $13.5 million Head Topics - Daily Botique; 9/13/24 The settlement, if approved by a judge, will cover nearly 11,000 Bayada nurses in Pennsylvania. Bayada Home Health Care Inc., one of the nation’s largest home care providers, agreed to settle a class-action lawsuit in Philadelphia alleging the company failed to pay nurses for time spent updating the incoming nurse or caregiver on a patient’s condition and for time spent in mandatory training sessions the $13.5 million Philadelphia Court of Common Pleas settlement.Editor's note: Additional information is behind a paywall at the Philadelphia Inquirer.

Tennessee health-care company enters Triad with acquisition of White Oak of Burlington Triad Business Journal; by David Hill; 9/11/24 National Healthcare, a publicly traded company from Nashville, acquired Alamance County facility as part of larger purchase of senior living centers. ... It also has three behavioral health hospitals, 34 homecare agencies and 30 hospice agencies, in addition to Alzheimer’s and memory care units and related operations. ... [Additional subscription may be required.]

2024 NHPCO Facts and Figures Report now available National Alliance for Care at Home, Alexandria, VA and Washington, DC; Press Release; 9/10/242022 Data Show First Increase in Hospice Utilization Rates Since COVID The National Alliance for Care at Home (the Alliance) published the 2024 edition of National Hospice and Palliative Care Organization (NHPCO) Facts and Figures, an annual report on key data points related to the delivery of hospice care, including information on patient characteristics, location and level of care, Medicare hospice spending, and hospice providers. Facts and Figures – the leading resource for hospice providers and others interested in understanding the work of the community – has been published annually for over two decades by NHPCO. ... The findings in this report reflect patients who received care in Calendar Year (CY) 2022, or Fiscal Year (FY) 2022, provided by hospices certified by the Centers for Medicare and Medicaid Services (CMS) and reimbursed under the Medicare Hospice Benefit. This year COVID-19 continued to impact patient care as COVID-19 waivers were still in place through May 2023. These waivers included increased telehealth services. With 49.1% of all Medicare decedents in 2022 choosing hospice care, utilization of hospice increased in 2022 for the first time since 2019. The increase hints at a normalization of the utilization rates back to pre-COVID data. Hospice utilization rates increased across all race and ethnicity groups, with the largest increase among Hispanic Medicare beneficiaries seeing. The total number of beneficiaries enrolled in hospice care in 2022 was 1.72 million. Due to the unique impact of COVID-19 on 2020 data, those data are not included in many of the charts this year.

Enhabit foresees smooth sailing on near-term hospice growth Hospice News; by Jim Parker; 9/5/24 Enhabit Inc. expects consistent hospice growth even as it contends with payer and reimbursement headwinds for its home health business. The home health and hospice provider recently terminated its home health contract with the Medicare Advantage payer UnitedHealthcare, a subsidiary of UnitedHealth Group, citing nine months of unsuccessful negotiations. In addition, Enhabit and the rest of the home health industry are facing a potential 1.7% rate cut from the U.S. Centers for Medicare & Medicaid Innovation’s proposed 2025 payment rule. Meanwhile, Enhabit’s hospice segment continues to grow sequentially.

BrightSpring Health Services announces definitive agreement to acquire Haven Hospice, expanding hospice services into Florida Business Insider, Louisville, KY; by Globe Newswire Press Release; 9/3/24BrightSpring Health Service ... announced that it completed the acquisition of the assets of North Central Florida Hospice, Inc. and Haven Medical Group, LLC (collectively “Haven Hospice”), a Florida-based company holding a Certificate of Need (CON) for comprehensive hospice care services in 18 counties in north central Florida, effective September 1, 2024. “We are excited to welcome Haven Hospice into BrightSpring, expanding our existing hospice services into the CON state of Florida,” said BrightSpring’s President and CEO Jon Rousseau.  

Hospice care standards are important. Congress must be careful tinkering with them. NorthJersey.com, Special to the USA TODAY Network; by Patrick Maron; 8/28/24... As hospice care grows, real attention needs to be paid to the differences between nonprofit and for-profit centers.  [A] staggering  73%  of hospice programs today are for-profit and are driven by financial motives, ... Rep. Earl Blumenauer, D-Oregon, is drafting legislation that, if enacted, would represent the most significant reforms to date for hospice payment and oversight. Though Blumenauer’s bill, the Hospice Care Accountability, Reform, and Enforcement — or Hospice CARE — Act, is still in development, key provisions will likely include a new payment mechanism for high-acuity palliative services, changes to the per-diem payment process and actions to improve quality and combat fraud. The bill would also implement a temporary, national moratorium on the enrollment of new hospices into Medicare, to help stem the tide of fraudulent activities ... However, there are significant challenges for nonprofit freestanding inpatient hospice facilities like Villa Marie Claire in Saddle River. Most important, the proposed five-year moratorium on enrolling new hospice programs into Medicare could limit our ability to expand services, straining resources of the Villa ... What’s more, the legislation mandates more frequent inspections and enhanced oversight, which could lead to operational stress and higher costs. [Click on the title's link to continue reading.]