After an active 2019 in the mergers and acquisitions market Louisiana-based home health and hospice provider LHC Group (NASDAQ: LHCG) has fixed its eyes on further growth in 2020 and beyond.

LHC Group engages in M&A primarily through joint ventures with hospitals and health systems, which has been the company’s most active growth front. Though the JV M&A strategy is not unique among hospice businesses, their approach is rare among publicly traded hospice and home health providers.

“Our pipeline of potential joint venture partners is increasing as well with our value proposition resonating as strongly as ever. After completing $114.3 million in acquisitions in 2019, and today in 2020, we believe the current environment positions us to exceed this amount in 2020 and 2021,” LHC Group CEO Keith Myers said in an earnings conference call.

During 2019 and to date in 2020, the company has purchased 27 home health, 11 hospice, three home- and community-based services locations and one long term care acute hospital across 13 states and the District of Columbia. Most of these transactions involved hospital joint ventures.

For the fourth quarter of 2019, LHC Group’s net service revenue for hospice totaled more than $58 million with a gross margin of $21.7 million, compared to $53 million and $17.5 million for the prior year’s quarter.

For the full year 2019, the company’s hospice segment brought in nearly $227 million in net service revenue, earning a gross margin of $86,745. This is up from $199 million and $68 million in 2018, respectively.

The company has identified hospice growth — both organic and through M&A — as a 2020 priority, in addition to navigating the transition of their home health business to the Patient-Driven Groupings Model (PDGM), staff recruitment and retention and the development of new joint venture opportunities, Myers indicated in the earnings call.

A key component of the company’s growth strategy is co-location of hospice in markets where it already has an established home health presence.

Bi-locating and tri-locating hospice with other holdings allows the company to establish a longitudinal relationship with the patient that can extend throughout the continuum of care from home health and home- and community-based services to hospice, when appropriate.

“We’re making a very intensive push on adding hospice to markets where we already have an established home health presence,” LHC Group CFO Joshua Proffitt said. “Our goal is over the next five years to have at least 75% of our locations where we have home health, co-located with hospice.”