As nonprofits seek to build scale in order to compete with larger competitors, some are banding together in regional collaboratives.

In these efforts, the Southern Care Collaborative, founded in 2022, could serve as a model. The organization includes 11 hospice members operating in Florida, Georgia, North Carolina, South Carolina and Virginia. The hospices are pooling resources and joining forces to build economies of scale and payer relationships without any change in ownership.

“By aligning across multiple states, independent nonprofit hospices gain a stronger shared presence while retaining their local identity. This improves competitiveness against large for-profit operators and positions members as a coordinated, high-performing regional network,” James Dismond, CEO of member organization MiraSol Health, told Hospice News in an email. “Through the collaborative, members gain access to specialized clinical, operational, quality, workforce and analytics expertise that would be costly to secure individually. This accelerates improvement, reduces variation and supports consistent, high-quality care across all member organizations.” 

In 2024, the Southern Care Collaborative merged with another group of nonprofits, the Florida-based Synthase Collaborative, and it plans to continue to add new members as time goes on, Dismond said. 

Southern Care Collaborative’s current members include: AuthoraCare Collective, Avow Inc., Hospice and Palliative Care of Iredell County, MiraSol Health, Hospice of South Georgia Inc., Hospice Savannah Inc., St. Francis Reflection, Treasure Coast Hospice, Visiting Nurse Health System – Hospice Atlanta, Hospice and Palliative Care of the Piedmont, and Good Samaritan Hospice.

However, the organization is more than the sum of its parts, according to Dismond.

“As a unified group, we can negotiate more effectively with Medicare Advantage plans, managed care organizations and private payors,” he said. “By standardizing data, aligning outcomes reporting and leveraging our collective contracting strengths, we can ensure fair reimbursement and build stronger partnerships.”

The group’s member hospices also collaborate on shared compliance frameworks, audit preparation, policy development, training and risk-mitigation, in addition to partnering on government advocacy.

Members can jointly innovate care models, strengthen workforce strategies, modernize technology and expand upstream services, Dismond indicated.

“Members share resources and expertise in the areas where collaboration strengthens impact, such as data insights, training opportunities, policy updates and coordinated efforts in community education and outreach,” he said. “By pooling knowledge and shared challenges, we can better support patients, caregivers, and the broader ecosystem of care. At the same time, each organization retains its own brand and identity, programs and operational decision making. Members continue to lead their individual missions and maintain control of their services, teams and funding.”