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Home Care Trendicators – Consolidation in Private Pay Personal Care

By Stephen Tweed   

What will the future of private pay home care look like five years from now?  What are the trends in the industry that lead to that future?

One of the things we do at Leading Home Care is to monitor the Forces and Trends that are shaping the future of home care in America.  We’ve identified Five Forces and Ten Trends that we are monitoring.  Forces are those pressures that cause change. Trends are the patterns of change.  I’ll be writing more about these forces and trends as we go forward in 2018.

From Fragmented Industry to Consolidated Corporations

For the past ten years, I’ve been watching for the beginning of a trend in the private pay home care sector that would lead to consolidation in our industry.  Up until recently, private pay personal care was provided by 26,000 small companies with a median size of $1.6 million in revenue.  In the past three years as we have worked with our TOP 5% Mastemind Group, we have seen more mergers and acquisitions leading to larger consolidated companies.

In the first quart of 2018, we are seeing significant new movement toward consolidating the private pay home care sector.  Here are some examples we are following.

Humana – Based here in Louisville, KY, Humana is one of the largest Medicare Advantage insurance companies. Several years ago, they purchased a large private pay home care and geriatric care management company, Senior Bridge, based in New York City.  In the past few weeks, Humana has announced that it is acquiring Kindred At Home, the largest Medicare Certified Home Health company in the country. This was created a while back by the acquisition of Gentiva by Kindred.  Just this week, Humana announced that it is acquiring Curo Health Services, the second largest hospice provider in the country.  So here is a major player in commercial insurance and Medicare Advantage now owning the largest home health company, second largest hospice company, and a major provider of in-home personal care and geriatric care management.

Addus – Based in Frisco, TX, Addus was originally a large provider of Medicaid Waiver type personal care. The company was acquired several years ago, moved to Texas from Chicago, and has been acquiring home health, hospice, and personal care businesses.  Addus just announced the purchase of Albuquerque, NM based Amber Care, which brings all three lines of business.  Addus has 110 branches in 24 states.

LHC Group – Almost Family – Two of the largest publicly traded home health companies, LHC Group and Almost Family, announced a merger.  Both companies offer home health, hospice, and private pay personal care services.  While their primate focus has been on home health and hospice, both of these companies have ventured into personal in-home care.

Amedisys – Another of the large publicly traded home health companies, Baton Rouge, LA based Amedisys has also ventured into personal care with its Association Home Care division with operations in Florida, Massachusetts, and Texas.

Bayada Home Health – The largest privately held, family owned home health company, Moorestown, NJ-based Bayada has nine services lines including home health, hospice, private pay personal care, Medicaid Waiver home care, and non-medicare skilled nursing with over 300 offices in two dozen states.  Bayada has over 100 offices providing personal care on a private pay basis.

Briggs Healthcare – Briggs is a company that has served the health care industry for many years as a supplier of paper forms, medical supplies, and other resources.  As the demand for paper forms goes down, Briggs has made a strategic decision to enter the private pay personal care marketplace by acquiring small to mid-sized independently owned home care companies.  As of our last conversation, they had acquired ten home care companies and are working to integrate them into Briggs Home Care.

Comfort Keepers – Based in Irvine, CA, Comfort Keepers was one of the early home care franchises.  The company was acquired by a private equity group, and later sold to Sodexo, a large company that started in the institutional food service business.  The company has begun to implement a strategy of purchasing independent home care companies, re-branding them as Comfort Keepers, and operating them as company-owned offices.

Senior Helpers – Another of the early and fast growing franchise companies, the Timonium, MD based franchisor was purchased in 2016 by Alaris Capital Partners.  They have also developed a strategy to purchase independent agencies, re-brand them, and operate them as company owned offices.  The first company owned office is in Baltimore, near the company headquarters.

Stay Tuned for More Trendicators  

These examples represent the beginning of a much bigger trend in consolidating the in-home personal care sector.  What does this mean for you?  Stay tuned to future editions of our “Trendicators Report” to give you more details about this and other top trends in the home care industry.

Have a question about trends in the industry?  Contact us. 

To stay on top of trends in the industry, and how to prepare for them, join a Home Care CEO Mastermind Group.  

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