Literature Review

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.

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 ...

Humana to depart 13 Medicare Advantage markets Modern Healthcare; by Lauren Berryman; 9/4/24 Humana previewed its Medicare Advantage strategy for the coming plan year, including a decision to quit 13 counties where performance has been unsatisfactory, at the Wells Fargo Healthcare Conference on Wednesday. The Medicare Advantage heavyweight, which had 6.2 million members in those plans as of the second quarter, expects to lose a few hundred thousand enrollees in 2025 as it prioritizes profitable markets, Chief Financial Officer Susan Diamond told investors at the event in Everett, Massachusetts. In addition to leaving those 13 counties, Humana will offer fewer plans in some other areas, Diamond said. About 560,000 members will have to choose new policies for 2025, most of whom will have other Humana plans available to them, she said. ... Diamond did not specify what markets will be affected, but Humana will continue selling Medicare Advantage plans in every state. The company is committed to a presence in certain favorable regions, including south Florida, she said. 

State seeks input on Columbia Gorge hospital, Gentiva hospice care The Lund Report, Oregon and SW Washington; by Nick Budnick; 8/29/24 State officials are checking in on two health care acquisitions that have occurred since August of 2022, the absorption of Mid-Columbia Medical Center into California-based Adventist Health as well as a private equity firm's acquisition of Kindred Hospice. Now the state wants to hear how the renamed entities are doing: Adventist Health Columbia Gorge and Kindred Hospice Care. “OHA wants to understand how ownership changes may have affected health care services at AHCG and Gentiva hospice agencies,” according to a state announcement. “We’d like to hear from patients, health care providers, employees, and community members who have interacted with AHCG or Gentiva in the past year.”

For-profit Idaho home health powerhouse seeks expansion in OregonThe Lund Report; by Nick Budnick; 8/27/24Pennant Group wants to acquire home health and hospice agencies from Signature Group, an affiliate of Avamere Health. State health officials are reviewing a giant for-profit Idaho-based home health care company’s $80 million effort to buy home care and hospice companies around Oregon operated by Signature Group, also known as Avamere Health Care. Officials in the Health Care Market Oversight office of the Oregon Health Authority announced a 30-day public comment period on Aug. 23.

Nationwide home healthcare and hospice provider to pay $3.85M to resolve False Claims Act allegations U.S. Department of Justice Office of Public Affairs; Press Release; 8/20/24 Intrepid U.S.A. Inc., headquartered in Dallas, and various wholly-owned subsidiaries (Intrepid) have agreed to pay $3,850,000 to resolve allegations that Intrepid violated the False Claims Act in connection with two lines of its business: first, that Intrepid knowingly submitted claims to Medicare for home healthcare services for patients who did not qualify for the Medicare home healthcare benefit or where services otherwise did not qualify for Medicare reimbursement; and second, that Intrepid knowingly submitted claims to Medicare for patients who did not qualify for the hospice benefit. The settlement is based on Intrepid’s ability to pay.

4 health systems shrinking their hospital portfolios Becker's Hospital Review; by Alan Condon; 8/14/24 Merger and acquisition activity is picking up steam this year after a decline in deal volume during the pandemic, with some large health systems reorganizing their portfolios and offloading hospitals in various markets. Four health systems that have sold or plan to sell multiple hospitals this year:

3 of the fastest growing hospice companies Hospice News; by Jim Parker; 8/16/24 Three of the nation’s for-profit hospice companies have hit the accelerator on revenue growth, achieving triple-digit percentages. Each of these organizations — Traditions Health, Fortis Health and HealthFlex Hospice — appeared on Inc. magazine’s 2024 listing of the fastest-growing private companies in the United States. ... 

On-demand talent can push key objectives forward amid an increase in M&A deals Forbes; by Sunny Ackerman; 8/14/24 As we settle into the latter half of 2024, mergers and acquisitions and other business transformation initiatives are likely to be top of mind for many business leaders. Consider EY’s May 2024 “Deal Barometer,” which predicts that in the United States, “corporate M&A deal volume will increase 20%.” The firm also estimated that M&A deal volume will increase by 16% in the private equity world. ... Given the projected increase in M&A deal activity, I expect to see an increased need for on-demand talent in 2024 and beyond to push key objectives forward, executing strategic goals to close deals and facilitate seamless transitions post-closure. ...

Pennant’s home health, hospice growth ‘significantly ahead’ of prior expectationsHome Health Care News; by Audrie Martin; 8/7/24The Pennant Group Inc. (Nasdaq: PNTG) leaders highlighted the company’s significant home health growth Tuesday. They also teased continued expansion in the East Coast and elsewhere. “We are thrilled to report record-breaking second quarter results as we continue to experience momentum across all our service lines and create meaningful growth opportunities for local leaders and teams,” Pennant CEO Brent Guerisoli said during the company’s second-quarter earnings call. “Our financial performance and growth trajectory reflect the consistent efforts we have applied to every aspect of our business through our five key focus areas: leadership development, clinical excellence, employee engagement, margin and growth.” The Pennant Group is a holding company based in Eagle, Idaho, with independent operating subsidiaries that provide health care services through 117 home health and hospice agencies and 54 senior living communities across 13 states.

Hiring, Covenant Care transaction propelling growth at Vitas Hospice News; by Jim Parker; 7/25/24 Vitas Healthcare, a subsidiary of Chemed Corp., is reaping the benefits of this recent $85 million purchase of Covenant Health and Community Services hospice business, along with one assisted living facility location. The deal is structured as an asset purchase, which allows the buyer to assume liability for assets included in the transaction. It also brought Vitas into the Alabama market and expands its geographic footprint in Florida and marked the company’s entry into the assisted living space. This is Vitas’ first deal in several years, but more are likely on the way, according to Chairman and CEO Nick Westfall.

Guest column: Private equity poses threat to home health care The Gardner News; by Jane Pike-Benton. Worcester Telegram & Gazette; 7/21/24 Health care observers across the commonwealth are focusing their attention on a bankruptcy court in Houston to learn the fate of eight Massachusetts hospitals being sold at auction by Steward Health Care. Steward’s financial collapse has unsurprisingly brought scrutiny on private equity in care delivery to a crescendo. ...  Nationally, the number of hospice agencies owned by private equity nearly quadrupled from 2011 to 2019. Seventy-two percent of those acquired hospices were previously nonprofits. As policymakers work to stabilize a health care capacity crisis pushed to the brink by Steward, they cannot afford to lose sight of home health and hospice providers in the shuffle. Organizations like ours, many of which were founded with nonprofit missions well over a century ago, are essential to hospitals desperately looking to discharge patients.

Risky business: Home sweet home or nursing home? American Nurse - Perspectives; by Christopher Hirschler, PhD, MCHES; 7/18/24 In 2018, “Nursing homes: Good intentions, sad realities” chronicled Rita Hirschler’s experience in a nursing home after decades of being a private care nurse. In response to the ideas espoused in the article, namely that a person has a right to live and die in their home and risks are unavoidable whether one lives at home or in a nursing home, a commentator asked, “What is the solution?” ... According to the Center for Medicare Advocacy and Lu and Lu, ownership and sponsorship type have been shown to significantly impact the quality of care in nursing homes, with for-profits generally having lower staffing levels and poorer patient outcomes. The Centers for Disease Control and Prevention, Meyer, and KFF Health News say for-profit nursing homes now account for approximately 72% of the more than 15,000 U.S. nursing homes, and they provide varying levels of care to 1.3 million residents.