Aveanna Healthcare Holdings Inc. (Nasdaq: AVAH) has a strong appetite for acquisitions, but has held off due to high valuations in the hospice space and uncertain home health reimbursement rates.

Aveanna provides hospice, home health and private duty care services. The company sees positive growth momentum heading into the final months of 2025, Aveanna CEO Jeff Shaner said in an earnings call on Thursday.

Aveanna’s strategic sights in hospice and home health have primarily been focused on acquiring smaller assets, Shaner stated.

“We’re not a hospice buyer at the mid-teen multiples, we are more disciplined as a buyer,” Shaner said during the earnings call. “On the Medicare side, from an M&A standpoint, we’ve looked at a bunch of little or tuck-in type opportunities. We’ve not been in a position today where we’ve been ready to pull the trigger on a home health or hospice asset pending the final [home health] rule.”

Aveanna’s future strategic investments in home health and hospice will in part depend on how the dust settles on reimbursement, Shaner indicated. The U.S. Center for Medicare & Medicaid Services (CMS) has finalized its 2026 hospice payment rule, which took effect Oct. 1 and included a 2.6% increase in Medicare base rate payments. However, the agency has not yet finalized the home health rule, in whichCMS proposed a 6.4% aggregate cut to home health payments for 2026.

Decreases in reimbursement could challenge sustainability, as many hospice providers also offer home health services.

“We continue to voice our disappointment by the significance of these proposed cuts. I think for all of us, it’s just getting certainty,” Shaner said. “Give us a certain answer that we can read into the future.”

Atlanta, Georgia-headquartered Avenna’s geographic footprint spans 38 states. The company provides adult and pediatric hospice, home health private duty nursing and medical solutions, among other services.

Aveanna’s ​​overall revenue hovered around $621.9 million in Q3 of 2025, a 22.2% rise compared to the same period last year. Its adjusted EBITDA was $80.1 million during that period, 67.5% increase compared to the previous year.

Revenue growth was attributed to a $104.9 million increase in the company’s private duty service revenue and a $8.3 million rise in revenue for its home health and hospice segment.

The company’s home health and hospice service revenue reached $62.4 million in the third quarter, a 15.3% year-over-year increase driven by a total of 9,700 patient admissions.

Aveanna is focusing on five strategic initiatives to fuel the company’s growth, according to Shaner. These initiatives include enhancing payer partnerships, identifying cost efficiency opportunities, modernizing its medical solutions services, managing its capital structure and cashflow, and deeper staff and leadership engagement.

Aveanna has integrated a preferred payer strategy that has boosted hospice and home health revenue, an initiative the company plans to replicate to propel growth of its medical solutions segment, Shaner said.

“What we’re seeing now in home health and hospice is what the future of medical solutions will be,” Shaner said. “It’s been three years worth of our team staying focused on the preferred payer strategy … where we drive the majority of our volume and that really drives our growth. We’re proud of our home health and hospice team. They’ve done a great job.”