New Jersey-headquartered Ennoble Care has added five new states to its geographic footprint.
Ennoble Care provides home-based hospice, palliative and primary care in 15 states and the District of Columbia. The hospice and palliative care provider recently stepped into Florida, Kentucky, Mississippi, Ohio and Texas.
The new expansion presents an opportunity to bring more home-based resources to underserved aging populations, according to Ennoble Care CEO Kush Das. The company had existing locations in nearby regions.
“The Midwest and the South are natural growth areas for us because they sit adjacent to our core, historical markets in the Northeast and Mid-Atlantic,” Das told Hospice News in an email. “We have been in Georgia for a long time, and as we expanded westward, it made sense to serve the growing and largely underserved senior populations of the South and Midwest. [The] gaps are as real in these communities as anywhere else, and these communities have growing Medicare populations that want to age in place.”
Ennoble Care serves roughly 50,000 patients annually through its own electronic health record platform and value-based care model. Founded in 2017, the privately-owned company is backed by private equity and venture capital firms. Ennoble Care’s investors have included Northwestern Venture Partners, Pacific Lake Partners, Peterson Partners LLC, Partners Group and Health Velocity Capital, among others.
Ennoble Care’s strategic focus includes a combination of organic growth, value-based partnerships and “thoughtful acquisition” of high-quality home care providers, according to the company. The company’s New Jersey Housecall Practices program merged with Clare Medical in 2024 to form one of the largest house call organizations in that state. Ennoble Care also completed another merger with Resurgia Health Solutions that same year.
Ennoble Care operates an Accountable Care Organization (ACO) and participates in the ACO Realizing Equity, Access and Community Health (REACH) model. Designed to address healthcare disparities, improve care coordination and reduce costs, the payment model demonstration is slated to complete by Dec. 31.
Service diversification has been crucial to improving access and care coordination, according to Das. Ennoble Care’s interdisciplinary hospice and palliative care teams work in tandem with its house call program to address patients’ evolving needs, he explained.
“The right care setting changes as a patient’s needs change,” Das said. “That’s why we treat house calls, palliative care and hospice as one continuum instead of three separate service lines. A patient can move from home-based primary care into palliative care, and into hospice when that’s the right fit, without having to find a new provider or deal with a fragmented handoff at the moment they’re most vulnerable. When we own the full continuum, we’re able to guide patients to the right care at the right time.”
As the ACO REACH demonstration period winds down, Ennoble Care will transition to other payment models. The company plans to pivot to Medicare Shared Savings Program (MSSP) or the Long-Term Enhanced ACO Design (ACO LEAD) programs, depending on the billing parameters across each of its geographic locations.
Similar to ACO REACH, participants in the ACO LEAD model build preferred provider networks with organizations serving high-needs patients. Hospices, home health and skilled nursing facilities collaborate with ACOs to cover patients’ overall healthcare costs.
Ennoble Care has seen benefits from participating in ACO REACH, including timely access to hospice and lower hospitalizations at the end of life, Das indicated. The company’s median hospice length of stay is upwards of 40 days. This is more than double the national average of 21 day days as reported by the National Alliance for Care at Home in 2024.
The company sees hospice care as pivotal to building future momentum in the ACO LEAD and MSSP payment models, he stated.
“That ability to guide patients seamlessly is what has made the hospice carve-in work under ACO REACH, and it’s what will carry it forward into LEAD and MSSP,” Das told Hospice News. “Our hospice has been a core part of our strategy, and it will remain a core part of our LEAD and MSSP strategies. Integrating hospice under MSSP takes a little more work because of some structural limitations of the program, but hospice costs are still carved into the total cost of care.”
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