By the Bay Health, Mission Hospice & Home Care, Hope Hospice to Complete Triple Merger

Three independent providers — By the Bay Health, Mission Hospice & Home Care and Hope Hospice — will merge, becoming the largest nonprofit hospice network in northern California.

By the Bay and Mission in September announced their plans to merge. In the intervening months, Hope Hospice also joined the transaction. The organizations indicated that joining forces would make them stronger competitors in the marketplace as well as improve access to care in the communities they serve.

The merger will also bolster the combined company’s recruitment and retention efforts, according to By the Bay Health CEO Skelly Wingard.


“To be able to combine our organizations, hospice and home care, it really does expand that mission even further. So number one is being able to just reach more patients,” Wingard told Hospice News. “In business, scalability is so critical. If we’re going to have operating costs that allow us to provide this level of incredible care, it is the side of business that we have to pay attention to. We’re not-for-profit, so we’re not fighting for the deepest margin that we can get. However, we’re still a business, and so the ability to scale is really important as well.”

Each of the three organizations is a pioneer in its own right. By the Bay Health was the first hospice to operate in its home state. Mission was the first to launch in California’s San Mateo County, and Hope was among the earliest nonprofits to serve the East Bay Tri-Valley region near San Francisco.

The path forward will include integration of the three organizations’ operations, as well as configuring their leadership team, staffing and boards.


“Mission Hospice, By the Bay Health and Hope Hospice share a rich history and commitment to serving the Bay Area community with comprehensive end-of-life care, education, and grief support,” Mission Hospice CEO Dolores Miller said in a statement. “Together, we can provide even more families the compassionate care and comfort they deserve at one of the most vulnerable times of life.”

More hospice providers operate in California than any other state, according to the U.S. Centers for Medicare & Medicaid Services (CMS), making the region an increasingly competitive market. Favorable demographics are also driving demand.

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 CMS. Only Florida and Texas had similar rates, at 154,521 and 143,284 hospice decedents, respectively.

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, according to projections from the California Department of Finance.

Post-merger, the combined organization will have the capacity to serve more than 1,100 patients per day, with more than 500 community volunteers and 600 multidisciplinary staff who provide hospice, home health, palliative care, transitional care, pediatric care, bereavement counseling and dementia support. The organization will also include Mission House – the only residential hospice house in the region.

The combined company will also continue By the Bay Health’s existing affiliation with University of California at San Francisco Health.

“Merging with these two excellent partners protects our legacy in the East Bay, and it secures access to additional quality resources and services,” Jennifer Hansen, CEO of Hope Hospice, said in a statement. “As a stronger combined organization, we can continue to provide compassionate end-of-life care that prioritizes the needs of patients and their families.”

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