By the Bay Health to Merge with Mission Hospice & Home Care

By the Bay Health and Mission Hospice & Home Care recently signed a letter of intent to merge the two California-organizations.

Joining forces under one umbrella is a move to beef up their combined presence in an increasingly competitive hospice market, improve access to care and improve quality, according to spokespeople for By The Bay Health (BTBH) and Mission Hospice & Home Care.

“Our combined organization will strengthen not-for-profit hospice, home health and palliative care services for patients and their families in the Bay Area and beyond through our unified, mission-driven approach, commitment to community-based not-for-profit care and enhanced community services,” representatives of both organizations told Hospice News in an email. “The new organization – combining two of the longest-standing not-for-profit hospices in California – would be uniquely positioned to serve more patients and families.”


Established more than 45 years ago, By the Bay Health is among the oldest nonprofit hospices in California. The organization serves eight counties around the San Francisco area.

Previously known as Hospice by the Bay, the organization rebranded in 2021 to reflect a broadening scope of services. The nonprofit organization affiliated with the University of California at San Francisco (UCSF) health system in 2015. By the Bay Health hospice, palliative and pediatric care, as well as skilled nursing home health and grief support.

Mission Hospice & Home Care provides end-of-life, grief support and community education services to patients and their families in South Bay, California, and in the San Francisco Peninsula area. Established in 1979, the nonprofit’s other services include palliative and transitional care, along with other home-based care options and advance care planning.


The path toward affiliation will include integrating the two organizations’ operational processes, as well as configuring their leadership team, staffing and boards, representatives stated.

“BTBH and Mission are aligned in our missions and will collaborate closely in developing the strategic plan and management structure for the combined organization,” they told Hospice News.

The organizations indicated that California’s very competitive hospice market is among their challenges on the horizon.

Hospice utilization in the Golden State is the highest nationwide. About 156,000 Medicare decedents in California utilized the hospice benefit in 2021, according to the U.S. Centers for Medicare & Medicaid Services (CMS). Only Florida Texas had similar rates, at 154,521 and 143, 284 hospice decedents, respectively.

Swelling aging populations are driving up demand in the state. Seniors 65 and older represent 15.8% of California’s overall population, according to the U.S. Census Bureau. About one-in-five individuals statewide will fall into this age group by 2030, projected the California Department of Finance.

“We believe Californians deserve access to mission-driven not-for-profit hospice and home care,” the spokespeople said in their email. “With this changing health care landscape, the combination of our organizations enables the growth needed to sustainably continue to provide access to high-quality not-for-profit care across the wider Bay Area.”

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