Literature Review

2023 hospice index scores, by state Becker's Hospital Review; by Elizabeth Gregerson; 12/11/24 In 2023, the District of Columbia had the lowest hospice care index score among states while Maryland had the highest, according to CMS data released Nov. 26.  CMS collected state data between Jan. 1 and Dec. 31, 2023, on the quality of patient care measures, including facility observed rates of hospice care. Hospices earn points for each of the 10 claims-based indicators they meet between admission and discharge. Here are the hospice care index overall scores for each state: [listed in alphabetical order].

Humana in the headlines: 10 updates Becker's Payer Issues; by Andrew Cass; 12/10/24 From Cigna quashing merger speculation to naming a new CFO, here are 10 updates on Humana that Becker's has reported since Oct. 30: 

Vitas Healthcare unveils inpatient hospice unit at Franciscan Health Olympia Fields GlobeNewswire, Chicago, IL; Press release; 12/12/24 Residents of Olympia Fields and Chicagoland’s surrounding southern suburban communities can now access quality end-of-life care at the VITAS Healthcare Inpatient Hospice Unit at Franciscan Health Olympia Fields. Located on the second floor of the hospital at 20201 South Crawford Ave., this new facility is expected to serve more than 500 seriously ill patients each year. “We are grateful to have this hospice unit as part of our hospital campus, where we can provide compassionate care to patients and families during one of life’s most sacred and challenging times,” said Raymond Grady, president and chief executive officer of Franciscan Health Olympia Fields. “This unit meets a critical need in our community, offering comfort, dignity and spiritual support to those at the end of life.”

Hospice's legacy carried on by new local ownership PRLOG Press Release Distribution, Meridian, ID; by Doctor's Hospice of Idaho; 12/11/24 The locally owned and operated hospice facility known for its dedication to celebrating the lives of patients and providing exceptional care, Doctor's Hospice of Idaho, announced that they have been acquired by Kristopher Stice, Capital Eleven and Willowbridge Group. This strategic move marks a significant step towards further enriching the local hospice care landscape while continuing the legacy established by Cody Freston. "We are thrilled to embark on this journey with Doctor's Hospice of Idaho, a facility deeply rooted in the community it serves. Our vision is to build upon the legacy established by Cody Freston and bring a renewed focus on patient care and employee well-being." said Ashley Copeland, newly appointed CEO/Administrator of Doctor's Hospice of Idaho. "By combining our years of experience in hospice care with the values upheld at Doctor's Hospice of Idaho, we aim to create a world-class hospice that starts from within."

Gentiva Hospice sues Bristol Hospice over noncompete violations in Maine PressHerald.com; 12/7/24 Gentiva Hospice has filed a federal lawsuit against Bristol Hospice, claiming that a former employee shared confidential information to help Bristol establish a competing operation in Bangor, Maine. The lawsuit alleges violations of noncompetition and confidentiality agreements.

Killing of UnitedHealthcare CEO brings resentment of the health care system to the fore STAT Business, Boston, MA; by Bob Herman and Tara Bell; 12/6/24 The targeted killing of UnitedHealthcare CEO Brian Thompson has become a defining moment in the zeitgeist of American health care. The attack was a tragedy that adds to the country’s grim tally of gun deaths. But instead of eliciting sympathy, it opened the floodgates for an outpouring of rage, captured across social media and online forums, over the health care system — one that charges people the highest prices in the world, erects financial and bureaucratic barriers to getting care, and has plunged millions of people into debt. Social media posts have ranged from mournful to apathetic to joyful, including morbid celebrations of Thompson’s death. That deluge has forced people across the country to grapple with two heavy subjects at once: the callousness of a slaying, and an undercurrent of deep-seated anger at a health care industry that makes a lot of money by exploiting Americans. ... [Click on the title's link to continue reading.]

Top News Stories of the Month Nov 2024 - TCN Podcast Teleios Collaborative Network (TCN); podcast by Chris Comeaux with Mark Cohen; 12/4/24 What if the future of Hospice and Palliative Care depends on understanding the intricacies of industry integration and regulation?  Join us for an insightful journey through November's most compelling stories that have captured the attention of Hospice and Palliative Care Today's readership. Our conversation reveals the significant impact of national events, from elections to regulatory changes, on shaping news cycles and industry priorities.  Also, rising workforce demands and political changes, such as immigration restrictions, paint a concerning picture for the future labor pool in Hospice Care. We provide a comprehensive analysis of the month's key themes that may have been missed, like tackling issues from CMS payment cuts to the Justice Department's stance on UnitedHealthcare Group's acquisition of Amedisys. This episode is a must-listen for those seeking a deeper understanding of the critical yet often overlooked issues in Hospice and Palliative Care today, and Mark delivers another excellent masterclass on creating compelling headlines. 

Delaware Court of Chancery awards damages and other relief to Encompass Health and Enhabit for misconduct by April Anthony, other former officers, and private equity firms Vistria Group and Nautic Partners Associated Press (AP) - Business Wire, Birmingham, AL and Dallas, TX; 12/4/24 On Monday, Encompass Health and Enhabit won their lawsuit in the Delaware Court of Chancery related to breaches of fiduciary duty by April Anthony, Luke James, and Chris Walker while they served as the senior officers at Encompass Health’s former home health and hospice division, which is now Enhabit. The Court awarded judgment against private equity firms Vistria Group and Nautic Partners and the home health and hospice business now known as VitalCaring Group for aiding and abetting “the egregious breaches of the duty of loyalty” by Anthony, James, and Walker. The case was the subject of a 7-day trial in December 2023. After considering “the damning record presented at trial,” the Court found that, while employed by Encompass Health, Anthony, James, and Walker usurped acquisition opportunities falling within Encompass Health’s line of business, used Encompass Health’s confidential information, and swayed key Encompass Health employees to join them with the promise of equity in the home health and hospice competitor that Anthony now heads. 

Court Orders VitalCaring to place 43% of profits into trust for Encompass Health Hospice News; by Jim Parker; 12/3/24 A federal judge in Delaware has ordered home health and hospice provider VitalCaring Group and its private equity backers to share future profits with Encompass Health (NYSE: EHC). The case has a long circuitous history that dates back to 2022 when Encompass Health spinned off its home health and hospice business as a standalone company, now known as Enhabit Inc. (NYSE: EHAB) brand. At the time, VitalCaring CEO April Anthony was CEO of the Encompass home-based case segment. “Encompass is entitled to one recovery,” a court opinion indicated. “That recovery takes the form of an equitable payment stream of VitalCaring’s future profits to be administered via a constructive trust, certain mitigation damages, and attorneys’ fee.” The court ordered that 43% of VitalCaring’s future profits be placed in trust to benefit Encompass. The remaining 57% would go to VitalCaring’s private equity backers, the Vistria Group and Nautic Partners.

Addus taking a cautious approach to hospice deals Hospice News; by Jim Parker; 11/22/24 Valuations in the hospice space have led Addus Homecare (Nasdaq: ADUS) to take a more conservative approach to hospice transactions as it actively seeks home health and personal care deals. Hospice multiples reach record highs in 2020 and 2021, as much as 26x. Since then the price tags have reportedly come down, but they haven’t gone far enough, according to Addus President and COO Brad Bickham. The company also seeks to bulk up its home health business relative to the scale of its hospice operations. “First and foremost is the pricing aspect of it. But secondly, it’s probably sequencing to a certain extent,” Bickham said during the Stephens Annual Investment Conference. “Our hospice platform is certainly significantly larger than our home health platform. We have found that home health does a good job of feeding hospice in the markets where we do have that overlap. It’d be good to essentially catch up our home and health platform at the hospice side, and certainly it’s a cheaper valuation.”

VITAS Healthcare honors retired hospice veteran, announces new executive leadership Globe Newswire, Miami, FL; by VITAS Healthcare; 11/20/24 VITAS Healthcare, the nation’s leading provider of end-of-life care and a best-in-class healthcare employer, proudly announces four major executive leadership changes:

For-profit hospices increasing despite poor performance EurekAlert!, Weill Cornell Medicine; Peer-reviewed publication; 11/18/24 Hospices are increasingly owned by private equity firms and publicly traded companies, but recently Weill Cornell Medicine researchers found that they performed substantially worse than hospices owned by not-for-profit agencies. This is concerning as nearly 75% of hospice programs, which care for patients in their last stage of life, are for-profit. The study, published Nov. 18 in JAMA, highlights the need for policy interventions that focus on increasing transparency and accountability in hospice ownership. ... The researchers analyzed Consumer Assessment of Health Care Providers and Systems (CAHPS) data from January 2021 through December 2022. CAHPS, the national standard for assessing the quality of patient care, surveyed the caregivers of those who passed away in hospice by telephone and mail. The researchers compared measures for communication, timely care, treating family members with respect, emotional and religious support, help for symptoms, hospice care training, hospice rating and willingness to recommend. ... Of the 2,676 hospices included in the final analysis, approximately 25% were owned by private equity and publicly traded companies and 40% were other types of privately owned for-profit hospices. Though only 25% of the hospices surveyed were not-for-profit, they provided the highest-rated quality care including focus on managing pain, comfort, dignity and quality of life.

VITAS seeking large acquisitions in hospice CON states Hospice News; by Jim Parker; 11/13/24 As it considers potential acquisitions, VITAS Healthcare is focused on large assets in certificate of need (CON) states. VITAS is a subsidiary of Chemed Corp. (NYSE: CHE). The company this year made its return to the M&A market after a hiatus of several years. In April, VITAS acquired Covenant Health and Community Services’ hospice operations as well as one assisted living facility in an $85 million deal. With that transaction under its belt, more are likely on the way, according to Mike Witzeman, vice president and CFO for Chemed. “We are fairly optimistic on a pipeline of potential Covenant-size deals, but there are a few hurdles from an internal perspective that we would certainly want to keep in mind. First is we like CON states or states where there are restrictions on barriers of entry,” Witzeman said during a presentation at the UBS Healthcare Conference. “The second would then be locations that, generally speaking, have some size to them. That’s important, obviously, from a patient flow perspective, but also from a staffing perspective.” The third major consideration is the price tag. The Covenant deal was sealed at a multiple of 6x to 8x EBITDA. ...