The Centers for Medicare & Medicaid Services (CMS) launched the Guiding an Improved Dementia Experience (GUIDE) Model on July 1, which aims to create more comprehensive, coordinated dementia care. Some home-based care providers have been named participants in the program, and many more plan to get involved.

CMS hopes the GUIDE Model will improve the quality of life for people with dementia, enabling them to live longer in their homes and communities and reducing strain on their unpaid caregivers. It is a long-term commitment, set to run for eight years.

It will promote improved dementia care by defining and requiring a comprehensive, standardized care delivery approach that includes a standardized set of services for patients and their caregivers, an interdisciplinary care team and a training requirement for care navigators who are part of the care team, according to CMS.

The interdisciplinary care team will deliver services by creating and maintaining a person-centered care plan that details the patient’s goals, strengths and needs, as well as comprehensive assessment results and recommendations for service providers and community-based social services and supports.

“Working with a direct participant benefits the clients and family caregiver by providing a team-based approach to care,” Senior Helpers COO Mari Baxter told Home Health Care News. “This ensures comprehensive care for the client and involves all parties in the process, maintaining consistency and quality. The GUIDE Model also introduces families and clients to home care, keeping them safer at home and reducing hospital admissions.”

The Maryland-based Senior Helpers is one of the largest home care franchises in the country. And while it is not a direct participant in the GUIDE Model, it plans to be strategically involved with it moving forward.

CMS said nearly 400 participating organizations, including Lifespark, InHome Connect, Providence Home Care, and Andwell Health Partners, are building Dementia Care Programs (DCPs).

Given that GUIDE is a voluntary, nationwide model for Medicare Part B providers, it can benefit home care providers in several ways.

One such way is that it pays organizations to help them expand their DCPs and provides care coordination and service management. Another benefit is that GUIDE participants can contract with other providers, suppliers and organizations to meet care delivery requirements. These partner organizations can include both Medicare-enrolled and non-Medicare-enrolled entities. Home care providers may be able to partner with other organizations to gain participation if they don’t meet all the necessary guidelines.

“Participating in the model as a provider ultimately improves outcomes and reduces the burden on caregivers,” Baxter said. “This support can reduce caregiver strain and improve their ability to care for the client.”

The model is also expected to reduce Medicare and Medicaid expenditures by preventing or delaying long-term nursing home stays and reducing hospital, emergency department and post-acute care usage.

“We want to do whatever it takes to keep people out of the nursing home,” Lifespark COO Matt Kinne told Home Health Care News. “There’s a time and a place for nursing homes, but they are expensive. We know that by surrounding people with longitudinal, trusting, holistic relationships supported by geriatric expertise, which is how we’ve contemplated the GUIDE Model, we can eliminate a lot of low-value care.”

Lifespark, headquartered in St. Louis Park, Minnesota, offers a wide range of senior care services, including home health care, home care, home-based primary care and home-based urgent care.

Kinne emphasized that the GUIDE Model is valuable because it enables home-based care companies to focus not only on addressing dementia and comorbidities in patients, but also by providing support for families when they need it.

“GUIDE allows us to provide a care coordinator and resources that otherwise wouldn’t exist to support families and individuals living with dementia,” Kinne said. “It is funding, resources and the ability to support people with real care coordination, with real geriatric nurse practitioner expertise that can work alongside families with complicated medical issues and dementia.”

The GUIDE Model also aims to assist businesses in creating services that align with people’s needs, providing additional support within the currently fragmented system. Kinne said that given the U.S. health care system’s lack of coordination among caregivers, that is what will help individuals move toward a better quality of life.

However, Kinne emphasized that companies must prioritize long-term benefits for themselves and the families they care for when participating in this model.

“This is not an opportunity for the short term,” he said. “When we evaluate things like GUIDE, we think about something built to last for a decade that will change people’s lives. This is a long-term commitment and, I think, a really good move by CMS to invest in this and give companies like us the opportunity to demonstrate and show that there is a better way to care for seven million people in the U.S. living with dementia, many of which have informal caregivers.”

The post How Home-Based Care Providers Are Approaching The GUIDE Model appeared first on Home Health Care News.

Senior Helpers is one of those providers. The company operates a handful of training centers, which allow them to upskill caregivers. Each center is modeled to replicate an apartment, including a bedroom, living room and kitchen.

“They have to show us all their skills in each of those environments,” Senior Helpers COO Mari Baxter recently said during Home Health Care News’ Non-Medical Home Care Webinar Series. “If they’re lacking some skills, we’re going to show them how to do that.”

Maryland-based Senior Helpers is a home care company that operates over 380 franchise locations in the U.S., Canada and Australia. Senior Helpers is one of the largest franchise companies in the home care space. The company was acquired by Waud Capital, a Chicago-based middle-market private equity firm, in March.

Being able to replicate caregivers’ working environment allows Senior Helpers to bring an element of reality to training sessions.

These training centers have also allowed the company to widen its pool of caregiver applicants.

“We were able to take the individuals who always wanted to be a caregiver, but couldn’t afford to be a caregiver, or didn’t know how to be a caregiver, and train them,” Baxter said. “There was a whole group of individuals who were displaced during COVID, like restaurant workers. We went after that audience and said, ‘If you want to be a caregiver, we can show you how to be a caregiver.’”

Baxter noted that increased training has resulted in improved retention for Senior Helpers.

“If I have a caregiver who may feel overwhelmed with the client, as the client’s needs are progressing, I can bring them in,” she said. “We can spend time training them, upskill them, get their confidence built up, … it’s actually much more efficient and cheaper than trying to go out and recruit people all the time.”

AccordCare is another company that has been able to weather the industry-wide staffing storm.

Marietta, Georgia-based AccordCare is a home-based care company that operates in Georgia, Alabama, Florida, New Jersey, New York, North Carolina and South Carolina.

AccordCare CEO Brandon Ballew — also during the webinar series — said that the company is hiring more staff. Retention has also been improving.

Similar to Senior Helpers, Ballew sees value in extensive training for caregivers.

“You can constantly invest in them becoming a more rounded professional, [and] they give that back to you,” he said. “They’re now getting more dedicated to the company, as opposed to the client. Historically, we saw caregivers that wanted to work in their neighborhood, or work close to home, and they would go to one house and they were really more engaged with our client, less with you as the company.”

Caregivers’ greater dedication to the company has also been a strong word-of-mouth recruitment tool for AccordCare.

“They’re sticking and they’re starting to bring their friends, and we’re seeing a lot more of that as well,” Ballew said.

The post Senior Helpers, AccordCare See Results From Enhanced Training Programs appeared first on Home Health Care News.

In a crowded home care ecosystem, companies are constantly looking for ways to stand out.

For some that means putting innovative solutions in practice that will enhance operations and care services. For others, that means developing deep local roots to strengthen services in various communities.

On top of this, home care companies are rolling out services that will help differentiate their care delivery model from that of competitors.

Ari Medoff — CEO of the home care company Arosa — recently touched on the greater need for ingenuity in home care.

“I am constantly amazed at how big and vast our market is, and how few points of differentiation most of us in the industry have,” he previously told Home Health Care News. “We need more creativity around business models. We need more companies to try different things.”

HHCN recently heard back from six home care leaders on the aspects of their companies that they believe separate them from the crowd.

***

Home care faces significant market pressures typical of its growth shakeout phase, where market differentiation is necessary for survival. At Home Assist Health, our strategic response focuses on deepening community commitment through a person-first approach, evident in our person-centered care planning and employee-centric programming that prioritizes clients and staff.

We’ve integrated innovative solutions like Automation Edge’s bot for streamlined back-office tasks and Tap Root Ella’s AI for dementia care, enhancing care quality and efficiency. Recognizing increasing rates of chronic disease, we’re prioritizing health independence by expanding community health worker services and promoting self-management of health skills. Partnering with an Arizona non-profit, we’re providing diabetic-compliant meals to eligible members.

Our focus on workforce centers around students who are not only experts in what attracts them to a profession but are also our primary target for growth. We’ve expanded partnerships with high schools, community colleges, and Arizona State University, offering internships, apprenticeships, scholarships, and student-led HR consulting to nurture talent and enhance capacity.

We operate in the human services industry, where placing people at the center of everything we do is fundamental. Our goal is to promote and enhance human potential at every level. This guides our operations and ensures resilience during industry shakeouts.

— Sara Wilson, president and CEO of Home Assist Health

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To differentiate ourselves in the home care market, we leverage advanced technology and maintain strong human connections. Our primary competition isn’t other agencies, but private caregivers. Since leaving the Honor Care Network, we’ve partnered with Hellohire and Homecare Pro to streamline our hiring process. This automation reduces onboarding time, ensures thorough vetting and maintains high-quality care. According to the 2024 Home Care Pulse annual benchmarking report, our hiring conversion rate outperforms the top 5% of agencies.

Our innovative approach improves efficiency, reduces costs and allows us to deliver top-notch care while considering our clients’ fixed incomes. By integrating technology into our operations, we enhance accountability and remain competitive. Despite our technological advancements, we emphasize the human element by conducting in-person interviews and orientations to build trust and ensure we hire the best caregivers. This blend of technology and personal interaction sets us apart in a parity market.

By embracing innovation and prioritizing human connections, we remain efficient, relevant and committed to serving our community effectively. And, at the same time, the bonus for Cypress is the reduction of the costs of human capital, and the bonus for caregivers is the speed to hire increases exponentially. Our approach ensures our clients receive the best possible care. As our business manager has said for over 20 years, ‘He or she who has the caregivers wins.’ Having quality caregivers available is how we differentiate ourselves.

— Bob Roth, managing partner at Cypress HomeCare Solutions

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We believe that deep local roots are essential for home care companies to differentiate themselves from competitors. In practical terms, this means leveraging our community knowledge to provide clients with the resources they need at any time of day. If you require a reliable and trustworthy caregiver to spend that very night with an anxious, hospitalized loved one, we are the answer. Hand-in-hand with local knowledge is a strong base of exceptional caregivers. Their dedication and expertise will establish and maintain our reputation for quality, compassion, professionalism and reliability while building trust with the people we serve. These qualities matter most to those seeking home care services and can make or break an agency. Plus, they are a big part of our quest to reshape the meaning of personalized caregiving. Unlike large companies that struggle with local knowledge and small agencies that lack resources, we are unwaveringly focused on our communities and caregivers. This unique approach, tailored to the specific needs of the people we serve, sets us apart and helps us break the parity barrier.

— Doug Markham, CEO of Avenues Home Care

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At Senior Helpers, we differentiate from other home care companies by looking at outcome data for the families we serve. We utilize a proprietary LIFE Profile Assessment app with our clients that applies more than 18 years of data to create a customized care plan for each client. We then measure our client’s improvements and track any hospital readmissions or ER visits. We believe our services are non-clinical and highly skilled. Our caregivers are trained to care for clients with chronic illnesses such as Alzheimer’s, Parkinson’s and much more.

Most home care companies focus on private pay, or government payers such as Medicaid. At Senior Helpers, we excel in both these markets along with the underserved middle market. The middle market has the largest number of seniors, but it is very difficult to service. The seniors in the middle market don’t have the financial resources to afford traditional home care and they have too much money to have the government help pay for home care. Senior Helpers has developed customized fractional care programs called flexHOME, utilizing home care and technology to meet the needs of this growing market. We want to serve as many clients and families as possible and we need to be resourceful on how we serve them now and in the future.

— Peter Ross, CEO and co-founder of Senior Helpers

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Family & Nursing Care Select stands out with our expertise navigating all aspects of long-term care insurance (LTCI) for our clients. Our LTCI management team provides unparalleled, comprehensive, hands-on support and advocacy ensuring each and every client maximizes their LTCI benefits. We provide guidance and support with all the paperwork, troubleshoot issues and uncover potential additional policy benefits, thereby maximizing the value of each policy. We consistently receive raving feedback from our clients about our proactive communication, and how supportive our LTCI team is from the first discussion when initially setting up care through the entire life cycle of a client.

— Neal Kursban, CEO of Family & Nursing Care

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I believe that to differentiate yourself in the home care industry, organizations need to prioritize humanized experiences over transactional ones. At Nurse Next Door, our Happier Aging philosophy embodies this belief by delivering personalized and connected care. By nurturing relationships and empowering seniors to pursue their passions, we enhance their emotional, mental and physical well-being, celebrating aging as a vibrant stage of life. Our focus extends beyond our clients to our caregivers through our Caregiving as a Career initiative, aimed at industry transformation. We provide growth opportunities, guaranteed hours, and foster a supportive culture that attracts compassionate professionals. Valuing our caregivers ensures they feel fulfilled and appreciated, establishing Nurse Next Door as a caregiving career destination in home care.

— Cathy Thorpe, president and CEO of Nurse Next Door

The post ‘We Need To Try Different Things’: How 6 Home Care Providers Stand Out In A Crowded Market appeared first on Home Health Care News.

The demand for personal home care services does not have a cap on it, and there will be more seniors than ever in the U.S. over the coming decade. But that doesn’t mean it’s an easy service to deliver right now.

In 2024, providers need to find business models that actually make sense – from their perspective, and from the client’s perspective.

For now, there are only a few primary payers for home care services: Medicaid, clients themselves (private pay) and Veterans Affairs (VA). Then there’s long-term care insurance and Medicare Advantage (MA), which tend to make up a smaller slice of providers’ revenue pies.

Staffing is one driver that keeps that demand out of reach. Providers can only care for as many clients as they have caregivers. On that end, Senior Helpers COO Mari Baxter recently said during Home Health Care News’ Non-Medical Home Care Webinar Series that there was a “light at the end of the tunnel” when it comes to staffing woes.

But then there comes affordability. One point that’s been driven into the ground is rising billing rates in home care services since the COVID-19 pandemic. As costs have gone up, there are less clients willing and able to pay for services.

Seniors and their families may need personal care services, and they may want them. But if they are unable to afford them, it does no good for a business.

That’s why providers are currently looking for sweet spots, or areas of business where they can deliver care, and also make a reasonable margin off that care.

That may mean finding the right Medicaid markets, too. Some of the largest and most successful providers have recently left states due to operating difficulties. Addus HomeCare Corp. (Nasdaq: ADUS) left New York this year, Help at Home left Alabama last year and Bayada mostly exited the Medicaid market in Florida in 2022.

”There are differences in marketplaces,” Tribute Home Care CEO John Sneath said during the webinar series. “We’ve discovered we need to get better at figuring out what those are.”

In addition to finding those sweet spot markets, providers are also looking for sweet spots in operating models, such as short-hour stays in private pay, alternative government models and value-based care models.

“I think you have to diversify,” Baxter said. “You have to look at all avenues. And we’re trying to get to all clients, not just the people that can afford care.”

This week’s exclusive, members-only HHCN+ Update explores how the business model behind personal care is changing, and why it has to.

Billing rates and short stays

The Maryland-based Senior Helpers is one of the largest home care franchises in the country. It was recently acquired by the private equity firm Waud Capital.

Baxter said that staffing is improving because of internal initiatives at Senior Helpers, but also just because of the market.

“I don’t feel the situation today is nearly as drastic as it was several years ago,” she said.

AccordCare CEO Brandon Ballew, also during the webinar series, said that the market has especially improved over the last 12 months.

Meanwhile, billing rates are plateauing in some areas, which is great news for providers.

Senior Helpers saw billing rates go up $4 to $5 per hour over the last four years, and in some cases, more than that.

“That probably slowed down last year, I think everybody kind of got to a certain level, and now it’s back to the smaller, more moderate increases,” Baxter said. “And I’m hoping that slows down further again.”

Still, a plateau doesn’t necessarily bring in folks that have already been priced out. There are many Americans who could once afford care that no longer can.

They are a part of the “forgotten middle.” They don’t qualify for Medicaid, but they also don’t have the ability to pay out of pocket for services.

Baxter says Senior Helpers has seen some clients pull back on care. She sees that as troublesome, because “if you need care, you need care.”

That brings us back to the core question of today’s personal care market: How do you tap into near-unlimited demand with the limited pricing options that exist?

Senior Helpers has responded with its flexHOME program, which is its short-hour commitment.

“At one point, you had to have at least eight or nine hours of care per week, or maybe even 20 hours per week,” Baxter said. “You had to have a minimum, and that minimum is no longer part of what we believe is the fair and the right thing to do. So we’re encouraging no minimum hours.”

Instead, Senior Helpers is going into communities and encouraging those who need it to get fractional care from the company, whether it’s after a surgery or during another time of need.

Baxter sees that as a home health-type model, in fact.

“They come in, they do 15 minutes, and then they leave,” she said. “It’s not an overnight process, you have to build it, you have to target neighborhoods that are over 55 communities. You’re not going to break even the first couple of weeks on this, it takes time to build up. But what we have seen is that most of these clients convert from 15 minutes, to 20 minutes, to 30 minutes, to several-hours shifts. You have to be patient.”

Most home care providers still carry a minimum requirement. It allows for a more smooth business operation, but could also be an impediment to future growth.

“​​When we do competitive analyses, … it is incredible how few providers offer short hours now,” Sneath added. “I think the number has shrunk. It’s really hard to do, obviously.”

Sneath’s Tribute Home Care is a home care provider that operates in Massachusetts, Maryland, Illinois and Northern Virginia.

AccordCare is likewise trying to take aim at that middle population, through shorter hours and also technology.

The company believes that technology in the home is one way to bridge the payment gap for those in the forgotten middle. A caregiver may not be affordable at all times, but with the right technology – the theory goes – a provider could still fill in the gaps.

“Can I marry that technology with the caregiver in order to still meet the needs?” Ballew said. “We’re still early in the innings, but I’m seeing that as being a viable solution for that mid group because that’s going to be a cheaper alternative than the full six- to eight-hour shift.”

The Atlanta-based AccordCare provides home health and home care services in Georgia, Alabama, Florida, New Jersey, New York, North Carolina and South Carolina.

Ballew admitted that the company has seen “nothing of great success today” with that strategy, only having dabbled in it. It will remain a commitment moving forward, however.

New models and standing out

The short stays, in their own right, are a more unique home care model. They’re unique enough that Seniors Helpers created the name flexHOME for them.

Ballew also said there’s some payer interest for those short-hour clients. That’s one reason home care providers have been turned off from Medicare Advantage (MA) in the past – the volatility and small number of client hours.

“Medicare Advantage is actually starting to be a faster growing group for us,” Ballew said.

There’s also the GUIDE Model, which is the Centers for Medicare & Medicaid Services’ (CMS) recently unveiled dementia care model.

That’s another area home care providers will be able to step into in the future.

“We’re looking at that as a real opportunity for us, and I think everybody is,” Baxter said. “You’d have to have your head in your sand not to.”

But while there may be excitement for the GUIDE Model, there’s a whole lot that home care providers can do to differentiate other than just that.

Home care standards vary by state, but the business model generally doesn’t. New models, new payer sources and new ways of thinking will be a major theme over the next five years.

“I am constantly amazed at how big and vast our market is, and how few points of differentiation most of us in the industry have,” Arosa CEO Ari Medoff said on the webinar series. “We need more creativity around business models. We need more companies to try different things, whether that’s short hours, [or] new service lines. I know that we have a tremendous opportunity with care management.”

The post Home Care Providers Looking For Care ‘Sweet Spots,’ Trying To Meet Clients Halfway appeared first on Home Health Care News.

The Medicaid Access Rule has been heralded by home care providers as a mostly good rule with one misguided piece: the 80-20 provision. And while that provision’s potential impact has been discussed ad nauseam, one area that hasn’t been considered as much is the effect it will have on private-pay home care providers.

Billing rates have already soared in private-pay home care since the COVID-19 pandemic, which has forced providers to get creative.

Some have decided to take on more payer sources like Medicaid and Medicare Advantage, some have looked to drive efficiencies to keep private-pay costs down, and others have decided to tailor their business to the most wealthy. Many have also taken shades of each strategy.

The 80-20 provision is six years away from implementation, but the regulation itself could immediately begin to affect how Medicaid programs operate. Eventually, it will inflate the wages that caregivers are being paid in home- and community-based services (HCBS).

And, thus, it also could affect the perception of caregiver wages in private-pay home care. If one area of an industry begins paying its employees more, the entire industry has to adjust. And that adjustment may be one that some home care providers can’t afford.

The costs go up

The 80-20 provision is yet another regulatory issue that home care providers are logging under: well meaning, with potential unintended consequences.

“With the 80-20 provision, my fear is it could have some unintended consequences, and I cannot stress enough that I believe caregivers deserve to be compensated well,” Jeff Stevens, the co-founder and CEO of Village Caregiving, told Home Health Care News. “There are positive aspects to the [Medicaid Access Rule], but I do believe it could reduce access… and I think it’s fair to suggest that it could raise costs for [all providers].”

For instance, if a private-pay home care provider operates in a market with other HCBS providers that are now directing 80% of reimbursement to caregivers, the baseline of home care wages in that area could increase rapidly, and swiftly.

In turn, it could force private-pay providers up their billing rates yet again, boxing out even more potential clients who can’t afford to pay those rates out of pocket anymore.

In certain states especially, increased Medicaid rates have made HCBS a more lucrative business. It has also leveled the playing field in recruiting and retention efforts between Medicaid-focused providers and private-pay providers.

The Centers for Medicare & Medicaid Services (CMS) certainly believes that the HCBS recruiting and retention woes will be mitigated by higher wages through the 80-20 provision.

And, while providers aren’t so sure of that, those new caregivers have to come from somewhere, potentially from providers who do not work in Medicaid.

“Data shows that direct care workers typically earn low wages and receive limited benefits, contributing to a shortage of direct care workers and high rates of turnover in this workforce, which can limit access to and impact the quality of HCBS,” Daniel Tsai – the deputy administrator and director of Center for Medicaid and CHIP services at CMS – said last month. “By supporting and stabilizing the direct care workforce, this provision will result in better qualified employees, lower turnover, and a higher quality of care, improving access to quality care for Medicaid beneficiaries.”

Not so sure

Senior Helpers COO Mari Baxter doesn’t think that the private-pay industry can afford to have many more significant hikes to billing rates, even if the cost to pay caregivers does go up with the 80-20 provision and similar policies in the future.

“I’m hoping it doesn’t drive up the cost of care on the private-pay side,” she told HHCN. “There’s going to be the natural progression of that, but we’ve already seen such a big increase over the last few years. I think we kind of need to slow down in [the future], frankly.”

AccordCare CEO Brandon Ballew doesn’t see that cost increase materializing as a result of the provision, however.

In the end, Medicaid rates – for the most part – are still much lower than private-pay rates in the vast majority of the country.

“Will there be wage inflation that might affect other payers outside of Medicaid reimbursement, because you’re moving them up there?” Ballew told HHCN. “I don’t personally think that’ll be the case. Medicaid tends to be one of your lower payers today anyway. So, if anything, it might get them more on par with some of the other payers. But again, they’ve got to put the money back into the reimbursement side in order to make that 80% still material as it competes with other payers for what is an extremely rare commodity.”

The post How The 80-20 Provision Could Affect Private-Pay Home Care Providers appeared first on Home Health Care News.

Thanks to impactful, large-scale transactions over the last decade, the collective face of home-based care has changed forever.

Traditional providers in both home health care and personal home care have merged. Payers became involved in the home-based care space like never before. Of late, retailers have too.

But it’s often easy to forget how the current landscape became what it is.

Below, Home Health Care News takes a look at some of the most important and impactful deals in home-based care over the last decade – deals that explain, in part, where the home health and home care industries are today.

‘Big time’ provider deals

This past decade’s first blockbuster remained one of the most impactful throughout the last 10 years.

In 2014, April Anthony’s Encompass Home Health & Hospice was acquired by HealthSouth Corporation for $750 million. HealthSouth took a swing at home health and hospice, merging an in-patient facility business with a post-acute care business.

Four years later, HealthSouth would rebrand completely, taking on the home health and hospice entity’s name. Encompass Health Corp. (NYSE: EHC) still exists today, but is again without post-acute care capabilities.

The HealthSouth-Encompass deal is like a few other deals in home health care, in that it set off a domino effect and a winding life cycle of a home health entity.

Anthony left Encompass Health in 2021, and after her home health and hospice company operated as a segment within the larger organization for nearly a decade, Encompass Home Health & Hospice was spun off into its own public company: Enhabit Inc. (NYSE: EHAB).

That happened in 2022, and two years later, Enhabit may land in the hands of a different owner after it concludes its own strategic review. Anthony now runs VitalCaring, which is backed by her, The Vistria Group and Nautic Partners.

Over the decade, larger health care organizations like Encompass Health have also bundled up services, and also unbundled them.

For instance, Brookdale Senior Living (NYSE: BKD) had one of the largest home health footprints for a long time. After COVID-19 woes, however, it offloaded that to a health system eager to get into home health care: HCA Healthcare (NYSE: HCA). LHC Group would later acquire some of the assets jointly owned by Brookdale and HCA Healthcare.

Ascension Health, too, teamed up with TowerBrook to buy the home health and hospice provider Compassus in 2019.

A theme that has been a mainstay, and will likely remain a mainstay, is health systems changing course on their strategic planning – and deciding whether to own home health care themselves or focus on core operations and partner with home health care instead.

“You’re seeing a lot of these facility-based providers divesting or spinning off assets,” Chaz Bauer, director at Fifth Third Securities, told Home Health Care News. “They realize they have fundamentally two different businesses. They’re very related and intertwined. But fundamentally, you have these facility-based businesses that are very centralized models, very capital intensive. Whereas home-based care businesses, they’re very decentralized; they’re very capital-light. Part of the motivation there – in unbundling – is they can unlock value for their shareholders by splitting those businesses.”

But then there’s the M&A that has come from within the home health sector itself.

For instance, “the merger of equals” that turned LHC Group into a true home-based care powerhouse.

In late 2017, LHC Group agreed to merge with Almost Family in a $2.4 billion transaction. A straight line can be drawn from that deal to UnitedHealth Group’s (NYSE: UNH) acquisition of LHC Group, which was finalized in 2023.

LHC Group and Almost Family’s merger is not an anomaly, either. Not long after, Great Lakes Caring, National Home Health Care and Jordan Health Services combined in a three-way merger to create another one of the largest home health companies in the U.S.: Elara Caring.

That deal was powered by the PE firms Blue Wolf Capital Partners and Kelso & Company.

PE money in home-based care has turned a lot of sizable providers into powerhouses. The aforementioned PE firms – Blue Wolf, Kelso, Vistria and Nautic – have all played a part in that, in the transactions mentioned already and otherwise.

That will also continue, particularly as some of the holding periods of the largest companies turn over. There’s also a chance, however, that PE firms direct more attention to other parts of home-based care – like personal care – given the uncertainty surrounding home health payment rates.

In home care, Vistria and Centerbridge Partners uplifted Help at Home, turning it into one of the largest providers of home- and community-based services (HCBS) in the country.

Waud Capital recently acquired the large home care franchise Senior Helpers. Wellspring Capital Management acquired Interim HealthCare’s parent company Caring Brands International in 2021. Last September, The Halifax Group acquired Comfort Keepers from Sodexo.

PE has always been involved in home care. Bain Capital’s 2018 creation of Arosa, one of the largest non-franchised home care companies in the country, is one past example.

In the future, it’ll be interesting to see if PE will drive more large-scale, impactful deals like it has in home health care over the last decade.

Payers enter the fold

Any commentary on the biggest deals in home-based care over the last decade needs to note increased payer involvement.

Enter Humana Inc. (NYSE: HUM).

When people think of the company’s home-based care investments, most go straight to its takeover of Kindred at Home.

But let’s take a step out of the last decade, just for a second.

In 2011, Humana acquired the home-based care provider SeniorBridge, which was doing just $72 million in annual revenue at the time. When that deal was announced, it was not exactly frontpage news. But one could argue that kickstarted a chain of investments that changed the M&A landscape in home-based care forever.

“SeniorBridge fills a growing market need and is consistent with Humana’s focus on delivering clinical care for seniors in their homes,” Michael B. McCallister, Humana’s chairman and CEO at the time, said in a statement. “Acquiring SeniorBridge will immediately expand Humana’s existing clinical capabilities with the addition of SeniorBridge’s national network of 1,500 care managers. The company does a terrific job of reducing hospital readmissions and emergency-room utilization, all while helping seniors achieve lifelong well-being.”

Humana’s home-based care thesis was already there, but the SeniorBridge deal was likely the deal that set the stage for what eventually became CenterWell.

“The deal was a game changer. I was initially surprised by the size of the transaction. It was pretty small by Humana standards,” Mertz Taggart Managing Partner Cory Mertz told HHCN. “It didn’t take long for Humana to tout the savings SeniorBridge created for their membership, saving it billions of dollars within the first couple years of the deal, by keeping their members at home and out of the hospital.”

Nearly 13 years later, Humana is one of the largest home health providers in the country through CenterWell Home Health.

The company, with the help of the PE firms TPG Capital and Welsh, Carson, Anderson & Stowe (WCAS), acquired and merged Kindred at Home and Curo Health Services. Yet another home health and hospice powerhouse was formed, this time under the watch of one of the largest payers in the country.

In 2021, Humana opted to take over a remaining 60% of the enterprise (it had previously owned 40%), which was worth over $8 billion at the time.

In 2022, it divested the hospice and home care operations of Kindred to Clayton, Dubilier & Rice (CD&R). Those divested assets became what is now known as Gentiva, led by David Causby, the former CEO of Kindred at Home.

The home health assets Humana held onto are now under CenterWell Home Health. CenterWell, overall, includes primary care, pharmacy and home health services.

In 2024, most large payers – namely the ones with large MA memberships – have some sort of home-based care capabilities. That was not the case when Humana acquired SeniorBridge way back when.

“This has been an ongoing development, and it’s really just vertical integration,” Bauer said. “The thought is: why not get into that downstream, and then be able to more directly control those costs and quality outcomes on the payer side?”

The other heavily involved payer is the only one that has a leg up on Humana in MA: UnitedHealth Group.

UnitedHealth Group’s Optum already had a variety of health care provider assets, but it decided to make its first big home-based care splash early in 2022 when it announced the $5.4 billion acquisition of LHC Group.

While payers liked the thought of vertical integration, large providers like LHC Group were also recognizing an existential threat to home health business: MA penetration. More MA beneficiaries meant fewer traditional Medicare beneficiaries, which meant a less sturdy financial leg to stand on.

UnitedHealth Group further cemented its interest not long after, when it made a $3.3 billion all-cash offer for Amedisys. That deal was agreed to in June of 2023, but is still pending.

Though UnitedHealth Group may have to divest some Amedisys assets to finalize the deal, the company will most likely have the largest home health market share when that deal closes. Estimates suggest Optum will have about 10% of the U.S. home health market under its belt.

Not only are payers now involved in the home health industry, but they are also creating scale.

“You can make an argument that Optum acquiring LHC group, and now Amedisys, is a scale transaction, like ones we’ve seen before,” Bauer said. “Because it puts together two of the largest providers to make an industry leader.”

New kids on the block

Like payers before them, another group of companies is now firmly involved in home-based care investment: retailers.

In fact, they’re so invested, they may not be labeled as just retailers five to 10 years from now.

CVS Health (NYSE: CVS) has a new health care services segment dubbed CVS Healthspire. Walgreens Boots Alliance (Nasdaq: WBA) has the same with its U.S. Healthcare segment.

Both of those segments are arguably the future of their respective parent organizations. And both include home-based care services.

Payers and retailers have different business models, but tend to want the same thing: pharmacy, primary care and home-based care services.

In 2020, Walgreens made an over $1 billion investment in VillageMD, a home- and community-focused primary care provider. After subsequent investments, it has backed VillageMD with over $6 billion.

After that, Walgreens found its next health care services asset in the health-at-home solutions platform CareCentrix. Though he is no longer in the position, CareCentrix’s former CEO, John Driscoll, was the initial leader of Walgreens new U.S. Healthcare segment.

“We continue to see strong results and potential for growth from our partnership with CareCentrix. Our full acquisition further accelerates our transformation to become a consumer-centric health care company, leveraging innovative platforms that extend our capabilities into fast-growing segments of health care,” former Walgreens CEO Roz Brewer said at the time. “CareCentrix is key to offering services to our patients at every stage of the care continuum, and to driving long-term, sustainable growth as part of our U.S. Healthcare strategy.”

Not to be outdone, CVS Health agreed to acquire the home- and value-based care enabler Signify Health in 2022 for $8 billion. Shortly after that, it got its primary care provider, too, with the over $10 billion acquisition of Oak Street Health.

While none of these assets are traditional home health or home care assets, this retailer involvement represents a seismic change in U.S. health care – and home-based care is a major part of it.

These companies could go after more assets in the future, or they could become major partners for those traditional providers.

Honorable mentions

It’s impossible to highlight every deal, but there are some that don’t fit perfectly into “themes” that are still worth mentioning.

The home care technology company Honor acquired the home care franchise brand Home Instead in 2021, for instance. In lieu of strictly partnering with providers to see its vision through, Honor opted to purchase Home Instead to speed up the process. The jury is still out on that deal, however.

Prior to agreeing to become a part of Optum, Amedisys also made plenty of deals that turned it into a multi-billion-dollar business.

It acquired the hospital-at-home platform Contessa Health in 2021 for $250 million.

It acquired Compassionate Care for $340 million in 2018, and AseraCare Hospice in 2020 for $235 million. Those two deals significantly bolstered its hospice arm.

Modivcare (Nasdaq: MODV) entered into the personal care game in a real way with its $575 million acquisition of Simplura Health Group in 2020 and its $340 million deal for CareFinders Total Care in 2021.

BrightSpring and PhaMerica completed a merger in 2019 that eventually led to today’s BrightSpring Health Services (Nasdaq: BTSG), which is now a public home-based care company.

Finally, Aveanna (Nasdaq: AVAH) – formerly a pediatric provider – entered into the home-based senior care world with its $345 million acquisition of Comfort Care Home Health in 2021 and its acquisition of Accredited Home Care for about $200 million later that year.

Addus Homecare Corporation (Nasdaq: ADUS) has executed several high-profile transactions of its own, most recently acquiring Tennessee Quality Care in a $106 million deal.

The post The Most Game-Changing Home-Based Care Blockbusters Of The Last Decade appeared first on Home Health Care News.

The Maryland-based franchise – which was previously owned by the health system Advocate Health – will be the foundation of Waud Capital’s home care platform moving forward. Overseeing that platform will be Steve Jakubcanin, the home-based care veteran and former CEO of Cornerstone Healthcare Group.

Here are five important things to know about Senior Helpers as it takes a different direction under new ownership.

Footprint and leadership

Currently, Senior Helpers has about 380 locations in 44 states, Australia and Canada.

Jakubcanin – who also spent time at AccentCare and Kindred Healthcare – will be the executive chairman of the board of directors at Senior Helpers. Waud Capital put $100 million behind him to kickstart a home care-focused platform back in February of 2023.

That won’t change Peter Ross’ role, however. Ross – the CEO and co-founder of Senior Helpers – will continue to lead the enterprise for the foreseeable future, he told Home Health Care News.

The Senior Helpers timeline

This will be the fourth major transaction that Senior Helpers has been a part of.

In October 2012, Levine Leichtman Capital Partners acquired a majority stake in the company. Then, in October 2016, Altaris Capital Partners acquired it.

In April of 2021, Advocate Aurora Enterprises acquired Senior Helpers. But about a year and a half later, in December of 2022, Advocate Aurora Health – the parent company of Advocate Aurora Enterprises – merged with Atrium Health.

That set the wheels in motion for the most recent deal, as Advocate Health (the combined organization) decided it wanted to partner with home care rather than owning it. Then, in March, Waud Capital announced it had acquired Senior Helpers.

Further acquisitions

It’s not yet clear whether Waud Capital has plans to inorganically add onto Senior Helpers through personal home care acquisitions elsewhere.

“That is to be determined,” Ross said.

But Waud Capital does already own other home-based care assets, such as: the home health provider Concierge Home Care; the home infusion companies PromptCare and CarePoint Partners; the physical therapy platform Ivy Rehab; Regency Hospital Company; and DS Medical, a home medical supplies company.

At the very least, Concierge Home Care and Senior Helpers will have a relationship off the bat. The two entered into a “strategic” partnership across Florida after the deal was announced.

“While this is not exclusive, we believe that this new partnership will benefit both companies moving forward,” Ross said.

New service lines

One of the more interesting items from the original press release was Ross’ indication that Senior Helpers could dive into more service lines under Waud Capital.

“We are very excited for our franchisee partners, teammates, caregivers, and clients,” he said in the press release. “The need for high-quality, in-home senior care has never been greater. We see opportunities to enhance our suite of senior services as part of the next phase of the company’s growth.”

When HHCN followed up with Ross, he did not offer any specific service lines just yet, but did say Senior Helpers would look at service lines “complementary” to its home care business.

The adult day operation

Speaking of other service lines, Ross already has Town Square, which is an adult day business.

Town Square, however, will not be affected by the Waud Capital transaction.

“I purchased Town Square from Altaris Capital in May of 2023,” he said. “Town Square is doing quite well. We are selling and opening new locations. I believe someday Town Square can be as successful as Senior Helpers.”

The post 5 Things To Know About The Waud Capital-Backed Senior Helpers appeared first on Home Health Care News.

Personal home care providers have begun to ditch blanket approaches, instead opting for more patient-by-patient specificity.

Going further to meet individual client needs enables home care to make a greater impact, while also increasing client satisfaction.

“One of my favorite geriatricians once said, ‘If you’ve seen one senior patient, you’ve seen one senior patient,’” Senior Helpers CEO Peter Ross told Home Health Care News. “It’s really important that we customize the care plans for each of the individuals, because everybody has a different situation they’re dealing with.”

Personalized home care

Patient-centric care is not a new idea. However, it may look different these days in comparison to a decade ago when technological advancements weren’t there yet in the home care industry.

Today, providers like the Maryland-based Senior Helpers are tailoring their service offerings with a more personalized philosophy using apps and other data-centric tools.

Senior Helpers is a home care company that operates over 380 franchise locations in the U.S., Canada and Australia. It’s one of the largest franchise companies in the home care space and was recently bought by Waud Capital.

A few years back, Senior Helpers launched its Life Profile assessment tool, an app that uses 20 years of data to assess the individualized needs of a senior.

“It’s an app we use with the family that provides a score — almost like a fuel gauge — and that score will basically dictate the chance of that person being readmitted into a hospital,” Ross said. “We’ve done almost 30,000 assessments with this tool and have learned we can create customized care plans while leveraging our care management, our care services, as well as our technology, to provide the best level of care.”

Advocate Health – Senior Helpers former owner – and the U.S. Veterans Administration (VA) have been strong advocates for the app.

“It’s something that’s very unique to Senior Helpers. There’s nothing like it out there in the marketplace,” Ross said. “It truly gives us a leg up on creating a customized care plan that goes right into our software center and allows the caregiver to understand exactly what we need to do for any given member.”

Technology, Ross added, has taken a lot longer to take hold in the home care industry than it should have. Now that seniors are getting more comfortable with wearables and smartphones, that allows providers the ability to leverage that technology to curate a more personalized care plan.

Curating a person-centered care plan

Every person’s care needs are different. With that in mind, a person-centered care plan is often based on an individual’s group of needs.

For many providers, compiling an exhaustive list of needs has become part of the home care process.

“With a common patient panel with diabetes or COPD, treatment is tailored uniquely to those characteristics or demographics,” Home Assist Health CEO Sara Wilson told HHCN. “We also look at a lot of interventions that target social determinants of health based on where somebody lives. Considerations such as food deserts, transportation, environmental surroundings — I would liken it more to a thumbprint versus a blueprint.”

There are so many factors that play into our general health, Wilson said, that it would be insufficient not to take all of it into consideration.

Educational limitations, literacy issues, language barriers are all lifestyle factors that mean more to an overall care plan than most would think.

Creating individualized care plans also creates buy-in from the members and patients.

“We ask, ‘What’s going to get you motivated to control your health?’” Wilson said. “Once a member identifies their wishes and aspirations, then you have buy-in. Now you get a client or patient who’s more motivated to participate in healthy habits.”

Another tactic Home Assist Health and its caregivers use is something called motivational interviewing.

“There are so many factors that you can’t simply resolve with a food pharmacy,” Wilson said. “In home care, sometimes we are the best entity to get into the home, listen to understand and build those authentic relationships using motivational interviewing to understand what does this person ultimately want out of their life. How are we going to use that one wish for themselves to be what motivates them to take control over their current health status?”

Moving care forward

In order to properly assess a home care client, there has to be a foundation built on trust and good data. Sometimes the first part of that equation is even harder to build.

“Our clients often exaggerate their abilities,” Griswold Home Care CEO Michael Slupecki told HHCN. “They understate their challenges. By having something like a wearable or other technology in the home when we’re not there, you can get a baseline for how folks are actually doing today versus last week. It allows us to address issues in a more personalized way.”

With more than 160 locations, the Blue Bell, Pennsylvania-based Griswold provides home care services in 30 states.

Slupecki has thought about the intersection of home care and home health a lot over the last few years. His experience as the former COO of Interim Healthcare has given him a unique perspective in how to better personalize home care.

“Today, I would say about 90% of the industry still does what it was doing 30 years ago,” Slupecki said. “That is assisting a person with activities of daily living. Which isn’t a bad thing. What we’re trying to do is be a little bit in between traditional home care with the intent of actually addressing the social determinants and all these other factors that we’ve now realized have a big impact on people’s health.”

One example at Griswold is the addition of virtual nurse visits.

After a traditional home care assessment, clients with Griswold will then meet virtually with a nurse to set up a clinical assessment.

“Depending on the client’s needs and chronic conditions, this nurse can deploy cuffs, scales, and odometers at virtually no cost to the client,” Slupecki said. “We’ve had interventions with these virtual nurses who may notice somebody’s blood sugar has gotten out of control. Those nurses will then tell a family member or a primary care physician who then mitigate likely disasters.”

The future of a more personalized home care environment is tied to innovative technology, a well-rounded caregiver support system and strategic partnerships with a shared vision.

“It’s all about collaboration,” Ross said. “It’s all about working with health care providers that continue to make adjustments and improvements to the care management and care coordination for these members.”

The post How Personalized Health Care Is Changing The Role Of Home Care Providers appeared first on Home Health Care News.

Three years after being acquired by Advocate Aurora Health, Senior Helpers has a new home.

The personal care company has been sold to Waud Capital, a Chicago-based middle-market private equity firm. Senior Helpers declined to disclose the transaction purchasing price.

The wheels for the acquisition began turning following Advocate Aurora’s merger with Atrium Health in 2022, Senior Helpers CEO Peter Ross told Home Health Care News.

“After Advocate and Atrium merged … they began working on a new strategic plan,” he said. “As part of that plan, they felt they’d rather work as a partner with their outside assets, [instead of] actually owning them. They made the decision, and Senior Helpers was one of those outside assets.”

Maryland-based Senior Helpers is a home care company that operates over 380 franchise locations in the U.S., Canada and Australia. Senior Helpers is one of the largest franchise companies in the home care space. In fact, the company earned the #172 spot on Entrepreneur’s 45th annual Franchise 500 rankings this year.

Once the decision to go to market was finalized, Advocate Aurora got the ball rolling quickly.

“Once they selected a banker in May of last year, the books were put together,” Ross said. “We went out to market, I think, in August. The books went out, initial bids came in, interest came in, and then management presentations were scheduled. We went through that in late September, early October. Then final bids and final candidates came in the November, early December timeframe. Then the final buyer was selected, probably in that mid- to late-December timeframe. Then came the final parts of due diligence, and everything else, before we got to yesterday’s closing.”

Ross pointed out that when it comes to acquisitions, the Waud Capital transaction isn’t Senior Helpers first rodeo. Before being purchased by Advocate Aurora, Senior Helpers was owned by the private equity firm Altaris Capital.

“The difference between the prior sales was that Advocate Aurora was the only strategic [buyer] that we’ve ever sold to,” Ross said. “The others, including this recent one to Waud Capital, have all been private equity firms, so the process is very similar.”

Though under a new owner, Senior Helpers will maintain a relationship with Advocate Aurora.

“Their decision to sell Senior Helpers with a decision of partner versus ownership, so we’re going to continue that,” Ross said. “When you’re part of a large health system — and I think Advocate would admit this as well — it’s not as easy as it sounds. There’s a lot of people that you have to educate within the health system, there’s a lot of layers to that. Navigating a large health system, it took more time, more patience. We did make some good inroads in some of the collaborations we did, it just didn’t happen as quickly as some of us hoped. At this point, we have a really good working relationship with Advocate’s care teams in the markets we’re in.”

Additionally, Senior Helpers believes that the company fits into Waud Capital’s overall ecosystem. The PE firm is no stranger to the post-acute care sector.

Waud Capital’s portfolio includes companies like Concierge Home Care, CarePoint Partners and PromptCare.

“[Waud Capital is] very focused on health care,” Ross said. “They’re looking at new avenues and service lines that can really help to expand Senior Helpers even further. They’re also very well-capitalized as a private equity firm. They’re really bringing a lot to bear for their resources and their capital to see what else Senior Helpers can be doing, what other types of business lines we can get into, to really help to grow. We’ve had significant growth over the course of our history, which is why we’ve been acquired four times.”

Though Senior Helpers’ time under Advocate Aurora was shorter than the company anticipated, Ross appreciates their time with the health system, and is excited for its next chapter with Waud Capital.

“I do really appreciate all that Advocate did for Senior Helpers, but we are energized for our next chapter with Waud Capital,” he said. “The team is energized, and our system is energized.”

The post New Service Lines, More Growth: What’s Next For Senior Helpers Under Waud Capital appeared first on Home Health Care News.

Most buyers in home health and personal care are signaling they’ll be more active in the M&A market this year.

That’s according to a new Mertz Taggart report, which included responses from over 50 potential home-based care buyers. Nearly 80% said they planned to be more acquisitive in 2024 compared to 2023.

But some of the biggest deals – or potential deals – are already well underway.

Waud Capital announced Thursday that it had acquired Senior Helpers – one of the largest home care companies in the country – for an undisclosed sum. That deal is intriguing for the rest of the personal care market for a few reasons, which we’ll get to below.

At the same time, the last two pure play home health and hospice providers on the public market are in periods of limbo.

Enhabit Inc. (NYSE: EHAB) is nearing the end of its strategic review process, which will likely end up in a merger or sale.

Meanwhile, UnitedHealth Group’s agreed-upon deal with Amedisys Inc. (Nasdaq: AMED) is under further scrutiny from the Department of Justice.

In this week’s exclusive, members-only HHCN+ Update, I take a closer look at three of the major home-based care deals that have happened, or could happen, this year.

The waiting game

Multiple times over the past few months, I predicted that Enhabit Inc. (Nasdaq: EHAB) would finish its strategic review prior to its March 7 fourth-quarter earnings call, which took place later than it had in the past.

That prediction did not come to fruition.

“The board, with the assistance of our advisors, is being comprehensive in its assessment of strategic alternatives, and discussions with interested parties are ongoing,” Enhabit CEO Barb Jacobsmeyer said on the company’s fourth-quarter earnings call. “We are in the later stages of our strategic review, but don’t intend to disclose developments unless and until we determine further disclosure is appropriate or necessary. We will not be commenting beyond that.”

Instead, Enhabit’s earnings call mirrored past earnings calls: it acknowledged its year-over-year contraction, while also honing in on its new payer contracts and improved hiring numbers.

“We are making significant progress demonstrating our value proposition to payers, as we negotiate new agreements with improved rates and are successfully shifting Medicare Advantage volumes into our payer innovation agreement,” Enhabit CFO Crissy Carlisle said during the call. “The revenue and adjusted EBITDA impact from this volume shift has not been enough to overcome the financial impact from the erosion of Medicare fee-for-service volume.”

That Enhabit problem, which forced a strategic review, is a problem most home health providers are facing.

But the company is making legitimate strides, and will be better off for the difficult transition it’s making now. The duties of its payer innovation team will eventually be the duties of one or more people at every home health agency.

Earlier reporting indicated that Enhabit would have a harder time finding a seller, and that it may end up with a private equity firm.

I do not think that is the case anymore, however, and believe there’s a larger chance now it’ll land in the hands of a strategic, which would be very significant. Enhabit, merged with one of the other top home health providers in the country, would create a home health powerhouse similar to the likes of Optum (if the Amedisys deal is completed).

Speaking of, Optum and its parent company – UnitedHealth Group (NYSE: UNH) – are still waiting on the Amedisys acquisition to go through.

As I wrote last month, that could take even longer than UnitedHealth Group’s acquisition of LHC Group, which took about 11 months. The 11-month mark for the Amedisys deal is upcoming in May.

So, for right now, Amedisys is not behind schedule comparatively. But, in addition to a general DOJ antitrust investigation into UnitedHealth Group, the DOJ is now reportedly considering a lawsuit to block the Optum-Amedisys deal.

It’s unclear how likely the DOJ nixing the Optum-Amedisys deal is at this point.

If it were to be blocked by the DOJ, however, legal processes would draw the timeline of the deal out significantly.

And, if the deal were actually blocked, it would be a massive deal for the home health industry. While Optum would still have LHC Group under its belt, it would end the company’s more massive home health land grab.

It would stop one of the most significant consolidations of home health assets we’ve seen in modern history. It could also change how payers and retailers, in general, view home health assets as M&A targets in the future.

For now, the states of Enhabit and Amedisys put the home health industry in a strange position. The two largest, public-facing assets representing the industry have relatively unclear futures.

Both are here, in the first place, largely due to Medicare Advantage (MA) penetration.

Part of the reason Amedisys opened its ears to acquisition opportunities in the first place was the shifting landscape of home health payment.

While smaller companies can sometimes be more nimble than the larger ones, Amedisys and Enhabit leaders’ recognition of that existential crisis – and difficulties dealing with it – is a troublesome foreshadowing for the thousands of other home health agencies.

Home care activity

An M&A expert recently told me to expect more personal home care dealmaking soon, as did Best of Care CEO Kevin Smith.

We have our first major deal of the year in the space now, with Waud Capital acquiring Senior Helpers. Sneakily, there has been a lot of turnover among the largest home care franchises over the last few years.

Honor acquired Home Instead in 2021. In the same year, Advocate Aurora Enterprises acquired Senior Helpers and Wellspring Capital Management acquired Interim HealthCare’s parent company Caring Brands International. Last September, The Halifax Group acquired Comfort Keepers from Sodexo.

BrightStar Care Executive Chairwoman and Founder Shelly Sun told me her company could be on the move in the next three to five years. And now, Senior Helpers is on the move again. 

I’m a tad surprised that Waud Capital went after a home care franchise to kickstart its home care platform, but for Senior Helpers, the deal makes a whole lot of sense.

Without the financials at hand, a private equity firm with significant home care interest is a far better place for a home care franchise than a health system undergoing a significant integration process. Advocate Aurora merged with Atrium Health in December of 2022.

Waud Capital put $100 million behind Steve Jakubcanin – a Cornerstone Health Group, AccentCare and Kindred veteran – earlier this year. Jakubcanin will serve as the executive chairman of Senior Helpers post-acquisition.

Increased home care interest in private equity may be taking hold due to reimbursement struggles in home health care. Investors interested in home-based care models may prefer – for the time being – providers more insulated from rate risks.

“I think we’re already seeing a little bit of that,” Rebecca Springer, lead health care analyst at PitchBook, told HHCN recently regarding that trend. “It’s not a full pivot, but we’ve definitely seen private-duty deals come through. Home- and community-based services deals have had a slow uptick in interest for a little while now. I think that’s because it’s an alternative to home health and hospice, but also because there’s a lot of green space there.”

Similarly, Havencrest Capital Management also recently started its own home care platform, Avid Health at Home. The firm began with an acquisition of For Papa’s Sake Home Care, and has since been very acquisitive across the country.

I expect Senior Helpers to similarly add on – whether in service lines or through home care acquisition – in the near-term future.

The post Deal Or No Deal: The Futures Of 3 Home-Based Care Companies appeared first on Home Health Care News.