BrightSpring Health Services completes Haven Hospice acquisition

BrightSpring Health Services (Nasdaq: BTSG) announced earlier this month that it has finalized its $60 million acquisition of the assets of North Central Hospice and Haven Medical Group, which collectively make up Haven Hospice.

The deal was first announced in June, and was finalized as of Sept. 1.

Importantly, the deal helps BrightSpring bolster its hospice footprint in Florida, which is a Certificate of Need (CON) state.

“We are excited to welcome Haven Hospice into BrightSpring, expanding our existing hospice services into the CON state of Florida,” BrightSpring President and CEO Jon Rousseau said in a statement. “The delivery of compassionate hospice care is critical for patients and their families, and we’re committed to delivering that to high-need Floridians. Our hospice services have been rated in the top five percent for quality in the industry, and with this expansion of services to Florida, we can provide high-quality care to more patients and their families during the most difficult time in their lives.”

BrightSpring, since going public earlier this year, has been an active acquirer. The Louisville, Kentucky-based company provides a wide range of home-based care services across all 50 states.

Compassus, OhioHealth finalize partnership

Compassus – one of the largest home health providers in the country – has finalized its partnership with OhioHealth.

Under the partnership, Compassus has acquired ownership interest in four home health locations and three hospice locations that were formerly led and managed by Ohio Health, which is a large nonprofit health system.

The partnership between the two will be dubbed OhioHealth at Home in partnership with Compassus. It was originally announced in June.

“We are excited to officially launch OhioHealth at Home in partnership with Compassus, bringing high-quality, patient-centered home health and hospice care to our communities,” Compassus CEO Mike Asselta said in a statement. “Our coordination with the community and OhioHealth hospitals in Marion, central Ohio Lexington and Athens will ensure patients receive seamless, comprehensive care right in the comfort of their homes.”

Compassus provides home health, home infusion, palliative, hospice and home care services across 30 states.

One of its main growth drivers over the years has been joint ventures and partnerships with large, regional health systems like OhioHealth.

Agape Care Group bolsters hospice footprint in four states

Agape Care Group, which is a portfolio company of Ridgemont Equity Partners, has acquired Crossroads Hospice locations in Oklahoma, Missouri, Kansas and Georgia.

Based in Spartanburg, South Carolina, Agape provides home-based hospice and palliative care services. Its family of brands already provided care across South Carolina, Alabama, Georgia, North Carolina, Kansas, Louisiana, Missouri, Oklahoma and Virginia.

Crossroads Hospice will continue operating independently in Tennessee, Ohio and Pennsylvania.

“The addition of Crossroads Hospice solidifies our decision to expand into the Kansas, Missouri and Oklahoma markets, where we have spent more than a year building the infrastructure to support this acquisition,” Agape Care Group CEO Troy Yarborough said in a statement. “We welcome the talented team members from Crossroads and look forward to focusing on care delivery and better serving patients in the Kansas City, St. Louis, Lenexa, Warrensburg, Oklahoma City and Atlanta markets.”

Advanced Home Health Care acquires Mobile Nursing Services

Advanced Home Health Care earlier this month announced that it has agreed to acquire Mobile Nursing Services, a home health provider based in Fort Madison, Iowa.

Based in Burlington, Iowa, Advanced Home Health Care provides services across the Southeastern part of the state.

“The acquisition allows Advanced Home Health to consolidate resources and provide the high-level of services both Advanced Home Health and Mobile Nursing customers rely upon to stay at home,” according to local news reports.

Advanced Home Health provides a variety of services in the home, including home care, home health care and pediatric care.

Cardinal Health to buy Integrated Oncology Network for $1.1 billion

Cardinal Health (NYSE: CAH) announced last week that it has agreed to acquire Integrated Oncology Network (ION), which is a physician-led independent oncology network. The deal is worth $1.115 billion.

Based in Dublin, Ohio, Cardinal Health is one of the largest health care companies in the country. Of late, it has significantly expanded its At-Home Solutions business. Now, it is diving deeper into oncology, which has also shifted further toward home- and community-based settings in recent years.

ION has more than 50 locations across the country. It provides “a complete and integrated continuum of care,” including diagnostic testing, radiation oncology, medical oncology, urology and other ancillary services.

As part of the transaction, ION will become part of Navista, Cardinal Health’s oncology practice alliance.

“Driving growth in specialty continues to be a top priority, and we’ve made investments to expand our offerings through both Navista and our acquisition of Specialty Networks,” Cardinal Health CEO Jason Hollar said in a statement. “With their proven model providing extensive support of community oncology across the cancer care continuum and healthcare ecosystem, we’re confident Integrated Oncology Network will further accelerate our oncology strategy and enable us to create value for providers and patients.”

Part of ION’s business model is “meeting patients where they are.”

“Integrated Oncology Network and Cardinal Health share a mission of helping community oncology practices deliver world-class patient care and a world-class patient experience to patients and families close to home,” ION CEO Barry Tanner said in a statement. “This partnership will give community practices the tools and technology they need to enhance and grow that mission and make a positive impact on patient outcomes.”

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KKR is an existing backer of BrightSpring, which had a share price of $13.85 as of market close on Friday.

Based in Louisville, BrightSpring provides home- and community-based pharmacy and health care services for complex populations. It offers home care, home health care and home-based primary care, and has a presence in all 50 states.

The company went public earlier this year.

In 2019, KKR and an affiliate of Walgreens Boots Alliance bought BrightSpring for $1.32 billion. Now, Walgreens is exiting that investment, while KKR is doubling down.

BrightSpring was one of a few Walgreens investments that involved home-based care over the past half decade. It also acquired the post-acute technology platform CareCentrix, and invested over $6 billion in the home-focused primary care provider VillageMD.

Since its IPO, BrightSpring has been focused on an “integrated” approach to home-based care.

“As we’ve been saying, since the IPO, I believe in the next year, we’re really going to start to see the fruits of more and more integrated care in the organization,” BrightSpring CEO Jon Rousseau recently said. “We, obviously, have very clinically appropriate home health to hospice transitions, [and] some personal care being delivered to the same patients, therapy as well, … but we see an opportunity to really increase that in the future. It takes focus, so we’re investing in an integrated care team to do that.”

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HCS-Girling Backs Pinnacle Home Care

HCS-Girling and Pinnacle Home Care announced earlier this month that the two companies have a definitive agreement to enter into a strategic partnership. Financial terms of the deal were not disclosed. 

The New York-based HCS-Girling provides home health and home care services, and Pinnacle Home Care is one of the largest home health providers in the state of Florida.

“Pinnacle is an important provider in the Florida market, having established a reputation for excellent clinical quality and a very strong corporate culture,” Jeffrey and Agnes Shemia, the co-CEOs of HCS-Girling, said in a statement. “HCS-Girling and Pinnacle both share a unique founding story as clinician-founder-led platforms. We are extremely excited about this partnership and the ability to service patients across geographies, working hand in hand with Shane and the Pinnacle leadership team to provide best-in-class care.”

Together, the two companies will “link the care continuum across two growing markets,” according to the release.

“Pinnacle and Girling are a perfect match with meaningful cultural overlap,” Pinnacle Home Care Founder and CEO Shane Donaldson said in a statement. “Both businesses are founder- (and clinician-) owned and operated and privately held. Both organizations recently celebrated 20 years of service in their respective communities, an important marker in how far both have come in their journeys as health care providers. Pinnacle looks forward to serving our patients, staff and referral partners for the next 20 years.”

HCS-Girling also recently acquired the personal care operations of Addus HomeCare Corp. (Nasdaq: ADUS) in New York.

Pinnacle’s chief sales officer said that the partnership with HCS-Girling will bring the company “considerable balance sheet strength.” The leadership teams will remain the same at each organization.

“We are so proud of our Pinnacle Family and all that we have achieved over the past several years,” Pinnacle President Michael Froning added. “Growth across the Florida home health market has not come without challenges, including the COVID-19 pandemic, as well as PDGM and RCD. As Pinnacle developed our longer-term strategies, we knew that future growth would require larger capital support, but we actively chose not to follow the path of our competitors to be acquired by a payvider or private equity, or the publicly traded home health providers.”

BrightSpring Health Services acquires Haven Hospice

On Monday, BrightSpring Health Services (Nasdaq: BTSG) announced a definitive agreement to acquire Haven Hospice, a Florida-based operator that provides services in North Central Florida.

The deal was worth $60 million, according to BrightSpring, and expands its service capabilities in a Certificate of Need (CON) state.

The company has closed multiple home-based care deals in 2024 already.

“We are excited to welcome Haven Hospice into BrightSpring, bolstering our existing hospice care line of business and expanding our hospice services into the CON state of Florida,” BrightSpring President and CEO Jon Rousseau said in a statement. “The delivery of compassionate hospice care is critical for patients and their families, and we’re committed to delivering that to high-need Floridians. It is extremely difficult to enter the Florida hospice market, and with this recent expansion of services, we can now provide high-quality care to more patients and their families during the most difficult time in their lives.”

In addition to hospice care, the Haven acquisition will also allow BrightSpring to provide advance care planning and palliative care. The deal is expected to close in the third quarter.

Compassus and OhioHealth enter home health, hospice partnership

The home-based care provider Compassus has formed a partnership with the health system OhioHealth. Specifically, the former will manage the latter’s home health and hospice service lines.

“We’re proud to collaborate with OhioHealth to deliver high-quality, patient-centered home health and hospice care to ensure patients and families have the support they need wherever they call home,” Compassus CEO Mike Asselta said in a statement. “As our teams come together, we’ll continue to focus on patients, partnership and innovation to deliver superior care.”

The Brentwood, Tennessee-based Compassus provides home health care, home infusion, palliative care and hospice care services. Its 7,000 employees provide care across 30 states.

The company also entered into a similar agreement with Bon Secours Mercy Health earlier this year.

As a part of the agreement, Compassus will “manage operations as both organizations work to ensure smooth continuity of care for patients and families.”

The OhioHealth network includes 15 hospitals, more than 200 ambulatory sites and home-based care services that serve patients in 50 counties in Ohio.

Northrim Horizon acquires Noble Hospice and Palliative Care

The private equity firm Northrim Horizon has acquired Noble Hospice and Palliative Care. Terms of the deal were not disclosed.

The deal took place through Northrim’s portfolio company ITC, which is a personal care provider, according to Hospice News.

“As long-term business builders, we try to view the world in decades as opposed to three-to-five years, which allows us the luxury to block-out short-term noise in markets,” Jack Lawson, Northrim operating partner and Noble’s new CEO, told Hospice News. “We believe hospice is an enduring segment within the broader home care industry and provides essential services to patients in a cost-effective and preferred setting. We are big believers that the best long-term care meets patients where they are.”

The Arizona-based Noble’s network includes a patient census of about 200.

“Noble has a strong track-record of growth, an experienced clinical and operations team and an enduring, patient-focused model of care that makes for a fantastic entry-point in the industry,” Lawson said. “We believe Noble Hospice has a business model and standard of care that will stand the test of time.”

HHAeXchange acquires Cashé

The New York-based home care technology platform HHAeXchange has acquired Cashé Software, a Minnesota-based home care operations and billing company.

“Today marks an exciting milestone as we join forces with Cashé. In addition to its robust product set, the company shares HHAeXchange’s passion for homecare, technology and innovative software,” HHAeXchange CEO Paul Joiner said in a statement. “Home care agencies need purpose-built technology to support them in delivering quality care. We are thrilled to partner with the Cashé team to collaborate on our vision of delivering the most comprehensive solution that drives operational efficiency, increases compliance, and improves health outcomes.”

Cashé already works with more than 400 home care agencies in Minnesota, according to the press release.

“For 20 years, Cashé has been focused on ensuring our customers can rely on our software to help them deliver the best care in the home,” former Cashé President Praba Manivasager, who will join HHAeXchange’s leadership team, said in a statement. “This commitment is strengthened by our partnership with HHAeXchange, and we look forward to working together as a team to accelerate our vision of building the software platform that sets the standard for efficient workflows and insightful data.”

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BrightSpring President and CEO Jon Rousseau discussed it as part of the company’s broader strategy at the Goldman Sachs 45th Annual Global Healthcare Conference Monday.

“Our playbook — which has been successful really now for over the last seven years — has been to drive volume growth, operational excellence, and then accretive acquisitions,” he said during the discussion. “On the volume side, we participate in very large growing markets, and so we like to focus on markets, on the provider side, that are growing at 6% to 8%.”

Based in Louisville, BrightSpring delivers care to patients in the home and in the community. The company focuses on complex populations, offering primary care, home- and community-based services, pharmacy services and rehab services to over 400,000 consumers throughout 50 states.

Rousseau called the three main pillars — volume growth, operational efficiency and accretive acquisitions — of BrightSpring’s overall strategy a “winning formula.”

What’s more, BrightSpring is looking to layer another growth strategy on top of the areas Rousseau outlined, and that is the company’s ability to provide value-based care. Home-based primary care will play a role in this effort.

“We have pharmacy, provider services and home-based primary care,” Rousseau said. “We are seeing about 400,000 people a day between our pharmacy and home health patients. That is just a tremendous amount of access to patients that are available to us, if we can serve them under our primary care, and serve them in a more attractive payer model. That’s a potentially really unique opportunity that we have into the future as well.”

On the M&A side, the company continues to prioritize proprietary deals.

“We tend to be a company that a lot of local owners want to sell to for the long term and be a part of our story for the long term,” Rousseau said. “A lot of our deals are proprietary, and then we bring our operational prowess and our scale, and our synergies to bear. We’ve typically been able to cut our acquisition multiple by about 50% to 100%. We usually get things onboarded within about 30 days, and the synergies come very quickly.”

Over the past five years, the company has completed nearly 60 transactions.

“Our acquisition strategy is to achieve three objectives,” Rousseau said. “Number one, to deepen and expand geographically. A good example would be, on the provider side, there are some CON states where you can’t participate without a Certificate Of Need. Number two, continuing to have a mix of our complementary services in each market and, and having those integrated care capabilities. Number three, just continuing to drive broad-based growth in the organization. There’s so much fragmentation in our markets and we can leverage our scale to a great extent by focusing on small transactions that fit those three.”

Ultimately, Rousseau believes that there’s an endless opportunity to complete accretive tuck-in acquisitions in the markets that BrightSpring operates in.

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Dover expands footprint

Dover Health is expanding its footprint into Illinois. The company has acquired Centered Care Hospice and Palliative Care, and Cornerstone Home Health.

Through the acquisitions, Dover Health will now serve Cook, DeKalb, DuPage, Grundy, Kane, Kankakee, Kendall, Lake and Will counties in Illinois.

Dover Health is a health care organization that offers a variety of services, as well as home health, hospice and palliative care. Currently, the company operates in St. Louis, Jefferson, St. Charles, Franklin and Lincoln counties in Missouri.

“Our leaders bring decades of experience and a mission-focused approach, ensuring that we invest in our caregiving team so they can deliver the best health care to our special population of patients,” Steven Burghart, president of Dover Health, said in a press statement. “We also specialize in coordinating with seniors housing to create the best collaborative team for everyone involved in supporting our seniors.”

Parkview Health teams up with CommonSpirit Health at Home

Parkview Health and CommonSpirit Health at Home have teamed up to form a new joint venture to provide home-based care across northeast Indiana. The partnership has been dubbed Parkview Health at Home and launched last month.

“As demand for home health care continues to grow, Parkview has a vision to expand access to the high-quality care our communities deserve,” Dr. Greg Johnson, regional market president for Parkview Health, said in a press release. “This partnership allows Parkview to work with another industry expert to enhance the patient experience. Together, we’ll maximize resources and best practices to meet the evolving needs of the region. As we continue to provide compassionate care, our goal is to advance the way it’s delivered.”

Parkview Health is a not-for-profit, community-based health system that serves northeast Indiana and northwest Ohio.

On its end, CommonSpirit Health at Home is headquartered in Milford, Ohio. It offers specialized home care, home infusion, hospice and medical transportation services nationwide. The company is the home-based care arm of health system CommonSpirit Health.

Under the JV, Parkview home health employees became CommonSpirit employees.

“Throughout the transition, both organizations worked hard to care for our people and respect their preferences, such as schedules and work locations,” Johnson said. “Change can be difficult, and we appreciate the flexibility and teamwork we’ve seen over the last few weeks. Our people truly make all the difference, and we look forward to serving our community with them as Parkview Health at Home.”

CommonSpirit Health at Home’s interim president and CEO, Trisha Crissman, believes that both organizations have the same key goals.

“Parkview Health and CommonSpirit Health at Home share common core, organizational values and are highly aligned around long-term strategies to expand access to care in the home,” she said in the press release. “Both organizations will partner together as we align our strengths to home health care services to care for more people in need within the community.”

BrightSpring Health Services closes multiple acquisitions

BrightSpring Health Services (Nasdaq: BTSG) has completed several tuck-in and strategic acquisitions.

These deals include a home-based primary care group in Arkansas, an institutional special needs health plan in Kentucky and Tennessee, and a home and community pharmacy in Texas.

All of these transactions took place at the start of May.

“We are excited to welcome these companies into our organization and further strengthen our medical and pharmacy services coverage for individuals in home health to long-term care settings,” Jon Rousseau, president and CEO at BrightSpring, said in a press statement. “At BrightSpring, we strive to grow and integrate our service lines to reach more people in need across the care continuum, endeavoring as best possible to deliver high-quality and impactful health services directly where people reside.”

Based in Louisville, BrightSpring delivers care to patients in the home and in the community. The company focuses on complex populations, offering primary care, home- and community-based services, pharmacy services and rehab services to over 400,000 consumers throughout 50 states.

Tuesday Health receives a $60 Million strategic investment

Tuesday Health, a value-based care company, has secured a $60 million funding round.

The investors include Valtruis, Blue Venture Fund, Mass General Brigham Ventures and CareSource.

“Leveraging clinical expertise, advanced data solutions, and cutting-edge technology, while partnering with Ohio’s largest Medicaid plan, its largest hospice provider and the unmatched palliative care experience of Mass General, Tuesday Health is dedicated to tackling one of healthcare’s biggest challenges-providing support and care in the right setting, at the right time, for those facing serious illness,” Jim Wieland, CEO of Tuesday Health, said in a press release.

Thyme Care locks down investment from Echo Health Ventures and CVS Health Ventures

Thyme Care — a value-based cancer care enabler — has received an investment from Echo Health Ventures, a strategic investment platform investing on behalf of multiple Blues health plans, and CVS Health Venture.

“The investment from Echo and CVS is a milestone moment for Thyme Care driven by our commitment to working with partners dedicated to rethinking how we deliver and pay for cancer care,” Brad Diephuis, chief operations officer and president at Thyme Care, said in a press release. “We’re thrilled to welcome them to the team, and we look forward to leveraging their deep industry insights.”

The investment will fuel the national expansion of Thyme Care’s value-based cancer care model.

“Cancer care today is challenging for everyone involved. Patients and families are forced to navigate a complex and frightening care journey, while providers struggle to offer personalized care in a rapidly evolving and often heterogeneous case mix, and health plans grapple with skyrocketing costs,” Kurt Sheline, a partner at Echo Health Ventures, said in the press release. “We believe Thyme Care’s member-centric and provider-integrated approach is unique and has the potential to transform this status quo toward a value-based future that aligns incentives to improve outcomes and lower costs.”

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In the first quarter, BrightSpring saw some mixed impact on EBITDA margin as a result of the company’s growing specialty oncology business. However, Jon Rousseau, president and CEO of BrightSpring, believes that the company is now in a stable position. He expects to see the margin go up throughout the rest of the year.

One of the factors behind this is BrightSpring’s home- and community-based services (HCBS).

“[In] home and community, we’re very focused on a number of procurement and operational initiatives as well, [and] we see about at least a point or 2% margin opportunity in those businesses over the next year or two,” Rousseau said Thursday during a discussion at the Leerink Partners Healthcare Crossroads Conference.

Based in Louisville, BrightSpring delivers care to patients in the home and in the community. The company focuses on complex populations, offering primary care, home- and community-based services, pharmacy services and rehab services to over 400,000 consumers throughout 50 states.

Rousseau also highlighted home-based primary care’s potential as a margin driver for BrightSpring.

“If we’re able to, ultimately, scale home based primary care — that’s a higher margin business too,” he said.

Overall, BrightSpring’s provider business has been a double-digit growth segment for the company. Rousseau called this characteristic of the broad based growth BrightSpring is seeing across the company.

“Home health and hospice grew near 10% in Q1, rehab grew well into the double-digits,” he said. “Community living and personal care — those are more Medicaid businesses, which have just been very steady for us, really good cash flow businesses. [It’s a] very nice mix of businesses, serving people in the home, on the provider side.”

Going forward, Rousseau identified home health, hospice and rehab as the main areas where BrightSpring expects to see the most outsized growth.

“We’re very optimistic that those businesses will continue to grow into the double digits for the long-term,” he said.

During the discussion, Rousseau also explained what he saw as the synergies between BrightSpring’s provider business and its pharmacy business.

“Most of our provider patients all get their pharmacy from our organization, so that’s a very meaningful synergy right there,” he said.

In 2023, a study published in the Journal of American Medical Directors Association found a 73% reduction in hospitalization for individuals who were receiving both home health care, and medication management from BrightSpring.

“I think that just shows the benefit of when people can address both their home health needs and their pharmacy needs,” Rousseau said. “Medication issues are one of the top two reasons why people go to the hospital … so addressing the pharmacy side of a patient who is high-risk is one of the No. 1 ways you can keep them out of the hospital and drive savings.”

Ultimately, BrightSpring sees the ability to drive home health referrals from its pharmacy customer base as a big future opportunity. Home-based primary care will also play a role in this as well, according to Rousseau.

“We’re putting care management resources to that and really the build out of our third pillar of home-based primary care was focused on driving more coordinated care, and driving more of these integrated care cross referrals,” he said.

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The other ingredient is the company’s medication management program for individuals in their homes.

“Our medication management program … has demonstrated a 73% reduction in hospitalizations when utilized together with our home health,” Jon Rousseau, president and CEO of BrightSpring, said during the company’s first-quarter earnings call on Thursday.

Based in Louisville, BrightSpring delivers care to patients in the home and in the community. The company focuses on complex populations, offering primary care, home- and community-based services (HCBS), pharmacy services and rehab services to over 400,000 consumers throughout 50 states.

Rousseau noted that the company’s ability to reduce hospitalizations is well above industry average.

What’s more, BrightSpring’s home-based primary care team demonstrated an 84% reduction in readmissions for IDD patients, and the company’s seniors and dual patients experienced 50% less hospitalizations, compared to the national average for similar patients, according to Rousseau.

“In our provider services segment, our patients often have complex health conditions, which require dynamic care plans, incorporating expertise across multiple disciplines,” he said. “We are proactive in coordinating care delivered through customized programs and plans. As care takes place in the home or community clinics, we have demonstrated an ability to deliver high-quality outcomes with lower costs.”

Another recent win for BrightSpring was escaping the Change Healthcare cybersecurity attack with minimal financial fallout.

“Our proactive best practices and operational capabilities were also recently evidenced when BrightSpring was able to mitigate any significant impact to revenue or EBITDA related to the Change Healthcare incident in the first quarter,” Rousseau said.

Overall, BrightSpring saw $2.6 billion in revenue in Q1. This is a 27% increase compared to $2 billion in Q1 2023.

The company’s provider services segment brought in $600 million, a 7% increase compared to $561 million during the same period last year.

Within the provider services segment, home health checked in at $242 million in revenue for the first quarter. This is a 9% increase compared to $223 million in during the same period last year.

“These results are driven by our provision of services in large and growing markets,” Rousseau said. “[It’s] the delivery of valuable services that reduce costs and improve outcome, our demonstration of strong quality and service levels, strong operational capabilities within a scale platform, and our ongoing pursuit of attractive near-term and long-term growth opportunities through a sales and marketing focus and commitment to strategic growth.”

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The company announced Tuesday that it has acquired a Maryland-based home health operation, the remaining equity interest in a behavioral therapy JV in Michigan and a long-term care pharmacy in Montana.

For one, the deals align with what is likely to be a relatively aggressive M&A strategy from the home- and community-based services (HCBS) provider. But they also are a good representation of the brand diversity that BrightSpring has, from home health, to behavioral health, to long-term care – all across the country.

“We are excited to welcome these companies and their employees to our uniquely scaled and differentiated BrightSpring platform consisting of leading and complementary health services,” BrightSpring President and CEO Jon Rousseau said in a statement. “These companies share our values and strong commitment to providing top-quality care to high-need patient populations who require it most. Together, we can reach more communities, delivering high-quality services and care directly where people reside.”

Based in Louisville, BrightSpring provides care to complex populations in the home and in the community. It offers primary care, HCBS, pharmacy services and rehab services to over 400,000 consumers throughout 50 states.

Its latest acquisitions “continue to support market penetration and market density growth strategies,” according to the company.

“At BrightSpring, we look forward to more opportunities for community and patient impact that result from partnering with strong local companies such as these, leveraging our unique platform strengths and capabilities to add value, and expanding and deepening our footprint in our markets,” Rousseau continued.

The home health tuck-in, specifically, was finalized on Jan. 1. The behavioral health deal was effective on March 1, while the long-term care pharmacy was effective on March 19.

Jefferies analysts wrote in a note Tuesday that the first-quarter deals serve as “early proof of management’s ability to execute on its strategy.”

“With less than 3 months as a public company under its belt, we interpret BrightSpring’s deal announcements as incrementally positive,” the note read. “A major piece of the pushback that we’ve received on the name was whether BrightSpring’s balance sheet and leverage profile would enable the company to complete additional M&A near term, so the completion of the deals is clear evidence that the company can fund and close accretive acquisitions that drive positive earnings surprises. Finally, with management suggesting on their 4Q call that the acquisition pipeline is robust, we think there is remaining sizable opportunity for BrightSpring to complete incremental deals this year.”

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BrightSpring Health Services (Nasdaq: BTSG), however, is trying to buck that trend.

“We have strategically positioned BrightSpring to be a major player in the areas of greatest need in health care and in some of the most exciting growth markets within health care services,” BrightSpring CEO Jon Rousseau said during the company’s fourth-quarter earnings call Thursday. “I am confident that, in each of these markets, BrightSpring will be among the long-term winners.”

BrightSpring Health Services is a Louisville, Kentucky-based provider of home- and community-based services (HCBS). The company serves complex populations that require specialized or chronic care.

As BrightSpring continues to build on its recent successes, Rousseau firmly believes that it is well positioned to be a leader in home-based care.

“There’s 5% of the population that makes up 50% of the spend in health care,” Rousseau said. “They need better solutions and have the need for multiple services. And where they’re at is in the home. Everybody needs their medications managed, everybody needs a doctor. Most people need provider services in their home. They don’t need just one service. Most providers only offer one service. We have the ability to offer a comprehensive set of care capabilities that drive better outcomes, but also to gain access to more volume and care opportunities in the organization.”

BrightSpring has two main service lines under its umbrella: pharmacy and provider services.

There’s an important overlap between those two service lines, Rousseau said.

“Every single one of our provider patients has an important medication management need and regimen,” he said. “For the majority of our provider patients we serve, we’re also providing the medication management and the pharmacy services in a more coordinated way. That’s upwards of about 35,000 additional referrals a year. That is a very unique capability set that we feel is imperative to drive value-based care type outcomes in the future.”

That’s the situation as it stands now. Over the next five or 10 years, BrightSpring hopes to capitalize on the referrals it could be taking as it continues to grow.

“As we look forward, there is a much bigger opportunity,” Rousseau said. “If we were to serve all of the services and needs that our patients have today, it would more than double the company. There are upwards of over 500,000 additional referrals a year that we could potentially be taking. That’s the goal as we continue to drive more integrated care.”

Going forward, Rousseau doesn’t want BrightSpring to offer more care because it can. It wants to leverage its home-based primary care capabilities to serve its patients in value-based models.

“That’s where we’re starting to derive more of the economic benefits for the great outcomes we produce every day,” Rousseau said.

BrightSpring’s home medication program, along with home care, has driven a 73% reduction in hospitalizations, it says.

In terms of growth, the company plans to be very aggressive and acquisitive in the next year. In fact, Rousseau called its pipeline “as large and attractive as ever.”

“Many folks want to sell to our company,” he said. “They look at us as a winner in the future of health care and a long-term home. So we have tremendous access. Our pipeline has 100 potential deals in it at any point in time. We’re very measured and deliberate about the deals we do. We have several deals we would expect to close in the March and April timeframe.”

BrightSpring officially announced the move to go public in January.

In Q4 of 2023, provider revenue increased year over year by $25 million — or 4.4% — to $589 million.

Total revenue for the company was a reported $2.4 billion, a 22.1% increase year over year.

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That includes, among many others, employee burnout.

Despite massive scale and resources, BrightSpring is still trying to figure out how it can keep its best workers from feeling burnt out, according to Stacy Bromell, the VP of strategic sales development at BrightSpring.

It’s not just frontline workers, either. Bromell said that, on average, case managers self-report being at an “8” level of burnout, on a scale of 1-10. Home health sales associates self-reported at a 7, while hospice sales associates self-reported at an 8 as well.

“And there’s a cognitive consequence that happens under those circumstances,” Bromell said last month at Home Care 100. “Because what’s happening when they’re under that level of burnout, when there’s that much of a population that has that kind of burnout, they’re in survival mode. And when you look at the literature, people that are in survival mode, they’re under the fight-or-flight part of their brain on an ongoing basis. They can’t think of things past the first crisis.”

Based in Louisville, Kentucky, BrightSpring provides home- and community-based services to complex populations. It provides care across all 50 states to 350,000 patients daily, and provides home-based care specifically to 250,000 patients daily across 40 states.

Bromell’s point is that, no matter how innovative an organization, employees experiencing that level of burnout are likely not going to be particularly receptive to new training, education or technology.

They are just trying to make it to the end of the day.

“Organizational alignment cannot occur under those circumstances,” Bromell said.

So, when there are two burnt out employees on each end of the referral equation, the process becomes more difficult.

One option is obviously to reduce burnout, but that’s easier said than done for home-based care agencies and health systems already short staffed.

“For sales folks in here, I encourage you to evaluate how many open-ended questions are being asked to the hospital versus closed-ended questions,” Bromell said. “Because if there’s a lot of closed-ended questions, your sales organization is in the fight-or-flight part of the brain. And that has to be remedied.”

Employee burnout can be accounted for with better “investigation” on health system and patient needs, in essence. That helps all three parties – the health system, home-based care company and patient.

“In our investigation with a hospital system or a physician, we can ask them [for] specificity,” Bromell said. “And that specificity brings the customer from that fight-or-flight part of their brain to the front part in the brain, and that’s where reasoning and problem solving occurs.”

Ultimately, that specificity leads to better conversations, and, in turn, better outcomes.

“It doesn’t take long to get a customer migrating that direction,” Bromell said. “And if we have this awareness, or we can impart that awareness, good things really happen.”

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