Get knocked down eight times, get up nine. That’s the mantra that the home-based care companies have followed after a volatile few months — and years — on the public market.

In July, most of them rebounded, at least to some extent.

“The same issues are still persisting — inflation is as challenging as ever, as is staffing,” says Stoneridge Partners Managing Partner Joe Lynch. “But these companies still have a future-facing, strong value proposition.”

The Stoneridge HHI increased 8.5% over the last month, while the PAI increased 6.5%.

Home Health Index

It is not an easy time to be a home health provider. Enhabit Home Health & Hospice’s (NYSE: EHAB) rocky start on the public market is evidence of that.

The Centers for Medicare & Medicaid Services has proposed payment rates for CY 2023 that, if finalized, are considered an existential threat to the industry. All the while, staffing costs and inflation are eating away at bottom lines.

As Enhabit went public in late June, its cost-per-visit rates were shooting up, it was in the wake of the ominous proposed rule, and, all the while, it was dealing with Medicare Advantage (MA) plans that weren’t yet willing to pay fair rates for its services.

But providers are still finding ways to innovate. Outside of home health, they are exploring new ways to bolster their value propositions. Amedisys Inc. (Nasdaq: AMED), for example, has taken its acquisition of the higher-acuity care enabler Contessa Health and hit the ground running.

“We continue to be pleased with the progress Contessa, our higher acuity segment, is making as it’s generating meaningful growth in Q2, and positioning itself for material ramp for both admissions and revenue for the second half of 2022,” Amedisys CEO Chris Gerard said on the company’s second-quarter earnings call.

Post-Acute Care Index

Addus HomeCare Corp. (Nasdaq: ADUS) is in an interesting situation. Unlike most of the companies in the post-acute care index, it is down only 0.7% YTD. It was also up over 11% month over month.

One contributing factor could be the company’s payer mix.

Given the above-mentioned proposed Medicare fee for service proposed rule for home health care, Addus’ personal care, hospice and home health diversification bodes well for it, as does its reliance on other payment sources than Medicare.

Quote of the Month

“They want to be at home around their things, in their castle. The benefit of home health care is that we enable people to stay at home and age in place independently for as long as they want.” – Lori Yount, Vice President of Operations for CareBuilders at Home

Read the Full Article Here: How Compassionate Home Care Can Help Your Loved One Live Their Best Life

See It To Believe It!

The Stoneridge Partners Home Health Index (HH Index) is updated monthly and measures the performance of these two publicly traded home health companies, all listed on the NASDAQ:

  • LHC Group (LHCG)
  • Amedisys (AMED)

Here are the results of the stock prices for the past two years:

Company 7/31/22 1 mos change YTD change 7/31/21 7/31/20
Amedisys 119.85 +14.01% -25.96% 260.62 198.54
LHC Group 163.06 +4.70% +18.82% 215.18 174.32
HH Index* 141.46 +8.45% -5.42% 237.90 186.43
S&P 4130.29 +9.11% -13.34% 4395.26 3271.12
Addus 92.81 +11.44% -0.75% 86.79 96.41

Although we track the performance of Addus, they are not included in our HH Index because very little of their revenue comes from Medicare.

Enterprise Value (EV)

EV (in M) 2022 2021 2020
Amedisys 4450 8750 7740
LHC Group 5940 6630 6390
HH Index Total 10390 15380 14130
Addus 1690 1490 1350

Enterprise Value (EV), aka Selling Price, as Percent of Revenue

Company 2022 2021 2020
Amedisys 201% 413% 393%
LHC Group 262% 319% 306%
HH Index Average* 232% 366% 350%
Addus 191% 192% 226%

The Stoneridge Partners Post-Acute Care Index is updated monthly and measures the performance of these six publicly traded post-acute care companies, all listed on the NASDAQ:

  • LHC Group (LHCG)
  • Amedisys (AMED)
  • Addus (ADUS)
  • The Pennant Group, Inc. (PNTG)
  • Encompass Health (EHC)
  • Brookdale Senior Living Inc. (BKD)

The above calculations are based on selling price being defined as Enterprise Value (EV), with data provided by Capital IQ. Enterprise value is defined as market cap plus debt, minority interest and preferred shares, minus total cash and cash equivalents. EBITDA is calculated using methodology which may differ from that used by a company for its reporting. (Home Health Index August 2022 | Stoneridge Partners)

SOLD Across the Country

  • Ohio-headquartered CommuniCare Health Services recently took over operations of hospice and home health provider Stonerise, expanding the company’s reach in its home state as well as West Virginia

SOLD!!! By Stoneridge

  • Stoneridge Partners is proud to announce the successful sale of a behavioral health agency in Arizona

View all of our closed transactions on our website

Exclusively Listed For Sale By Stoneridge Partners.
Do you know of any acquisitions that have taken place? We are interested in your comments. Contact us at Stoneridge Partners.

Non-medical home care franchisee.  $9.6+M in revenue.  50% Medicaid/30% Private Pay/ 14% VA/ 6% Misc.  Experienced management team to stay post-transition.

 Home Care /  Multi-State

Hospice.  45+ ADC.  Rio Grande Valley.  No CAP or regulatory issues.

 Hospice /  Texas

$2M revenue home care agency.  100% private pay.  Primarily non-medical.  Skilled designation, not Medicare-certified.  W-2 caregivers.  Region 8.  Accredited.

 Home Care /  Florida

Profitable private-duty home health agency in Northern Virginia.  $1.5M in revenue.  20+ years in the community.

 Home Health /  Virginia

Profitable home care franchise with consistent sales growth.  Revenue of $1.3M.  Great reputation within the community.

 Home Care /  Iowa

$40M+ home care agency with 20+% AEBITDA.  Primarily private-duty, non-medical (90%).  Medicaid waiver programs.  40% family caregivers.  Multiple locations.

 Home Care /  Pennsylvania

Colorado Springs and surrounding areas.  Opportunity to grow existing small hospice.  Motivated Seller

 Hospice /  Colorado

Medicare-certified home health agency.  Houston/Kingwood area.  Approximately $600k in revenue.  Accredited.

 Home Health /  Texas

I/DD provider offering SCL & FHP services.  $3M in revenue.  Recent rate increase.

 I/DD /  Kentucky

Hospice.  30+ADC.  No CAP or regulatory issues.

 Hospice /  Illinois

Behavioral Health/Suboxone Clinic.  $900k in revenue.  21 years in business with stellar reputation.  Single office, great opportunities for expansion.  All cash paying patient base.

 Behavioral Health /  Kentucky

I/DD residential services.  $11M in revenue.  Highly profitable agency with long-standing reputation.  Community Residential Services (CRS) 4-bed model & Integrated Community Supports (ICS) apartment settings.

 I/DD /  Minnesota

Well established home health agency.  $4M in revenue.  Fully staffed.  Profitable.  Good history of compliance.

 Home Health /  Missouri

Home Health CON in Montgomery County.  Profitable agency generating over $1.3M in revenue.  95%+ Medicare.  Built in marketing relationship and growth potential.

 Home Health /  Maryland

Skilled Home Health & Private Duty. $4.4 million in revenue. 22% census increase over last year. Established over 23 years.

 Home Health /  Florida

Medicare/Medicaid Home Health agency. $8 million in revenue. Long history in the community.

 Home Health /  Oklahoma

86 patient hospice located Northeast of Houston, TX. $4M+ in revenue with 20% + adjusted EBITDA. Full staff in place. Excellent record of compliance.

 Hospice /  Texas

Medicare-certified home health agency. District 7. Census of approximately 30 patients. Accredited.

 Home Health /  Florida

Hospice. 150 ADC. Strong growth. Expertly run with administrative team willing to stay involved. No CAP or regulatory issues.

 Hospice /  Southwest

Mental Health Treatment Center. $1.1M in revenue. Long-established, profitable practice. Full spectrum of medical treatment and therapy services.

 Behavioral Health /  Indiana

Medical Staffing Agency. $4.6M in revenue. Established over 25 years. Excellent rapport with regional hospital network.

 Other /  Kentucky

Medicare home health agency.  Health system relationship.  Rare KY CON opportunity, multiple counties

 Home Health /  Kentucky / Popular

Home health with $8M in revenue.  Medicare/Medicaid-certified.  90+% traditional Medicare/episodic.  Services central Texas and licensed for entire state.  Strong management team in place.

 Home Health /  Texas

Medicare-certified home health agency.  Houston-area.  Minimal census.

 Home Health /  Texas

Medicare-certified home health agency.  $1M+ in revenue.  Long-established agency with excellent community rapport.

 Home Health /  Texas

$19.5M large home care franchisee.  89% Medicaid.  Well-established company operating more than 20 years.  Phenomenal year-over-year revenue growth.

 Home Care /  Illinois / Popular

Home Health Index August 2022 | Stoneridge Partners

From Joe Lynch, Publisher of “Home Health Index.” Joe can be reached at [email protected] or 800-218-3944. Previous editions of this monthly newsletter can be searched for at the bottom of the home page of the Home Health Index. Links to Google Finance: Amedisys | LHC Group