Though the hospice space remains fragmented, mergers and acquisitions are driving up market share, particularly for large providers. Along with service diversification and application of emerging technologies, M&A is helping to drive growth among the organizations named in LexisNexis Top 100 Hospices of 2019.
With 4.5% of market share, VITAS Healthcare, a subsidiary of Chemed Corp. (NYSE: CHE), is the largest hospice provider in the United States in 2019, followed by Kindred Healthcare, HCR Manorcare, Amedisys, Inc. (NASDAQ: AMED), and Seasons Hospice & Palliative Care in the top five, according to the report.
“The annual rankings provide hospice providers with information to help them better understand their market positions, dynamics and environment for potential merger and acquisition activity and operational growth,” according to LexisNexis. “The insights also enable agencies to better tailor strategic planning, patient care and growth strategies by offering a detailed understanding of referral patterns and affiliations.”
The hospices are ranked by percentage of market share based on patient counts, looking at the claims associated with each provider. The market share percentages are the shares of all hospice provider claims nationally, not limited by region or geography, a LexisNexis spokesperson told Hospice News.
Rosemont, Ill.-headquartered Seasons Hospice & Palliative Care, the nation’s fifth largest hospice, attributed its growth in part to technology and the range of services it provides, such as music therapy and 24-hour call center staffed with registered nurses. The hospice is the largest employer of certified music therapists in the United States, a company spokesperson said,
“Our company success has hinged upon our focus on supporting our staff so that they can put patients and families first,” Annemarie Switchulis, President and COO. “Our frontline staff’s constant focus on providing excellent care at the bedside is the reason why our company has been able to honor the needs and wishes of so many facing the end of life.”
Among the systems contributing to Seasons’ are predictive analytics technology to identify patients in need of their services further upstream and to anticipate changes in the patient’s condition, a company spokesperson indicated.
No position changes occurred in the last year among the top ten hospices, according to previously unpublished 2018 data LexisNexis provided to Hospice News. Much of the movement in the remaining 90 was due to name changes following an acquisition rather than a change in market share, the spokesperson said.
The hospice merger and acquisitions market has been thriving in recent years, with several top providers such as Amedisys, LHC Group, and others prioritizing expansion of their hospice footprint through acquisitions.
Private equity interest in the hospice market has also been growing, driven by multiple factors, including industry fragmentation, increased acceptance of palliative care services, the aging population, the changing regulatory landscape, and movement towards value-based payment models such as the 2021 Medicare Advantage hospice carve-in or the U.S. Centers for Medicare & Medicaid Services’ Primary Care First Initiative.
Completing the top ten largest hospices were Curo Health Services, Compassionate Care Hospice, Compassus, Hospice of the Valley and Crossroads Hospice and Palliative Care.