Behind the Deal: Eden Health Expands Northern Nevada Footprint with Acquisition of A Plus Hospice

by | Dec 9, 2024 8:25 am | Home Health & Hospice

Eden Health, a 100% employee-owned healthcare provider operating across seven states, has expanded its regional presence in Northern Nevada through the acquisition of A Plus Hospice Care. The deal, effective November 1, 2024, was facilitated by healthcare-focused M&A advisory firm Agenda Health, headquartered in Austin, Texas. Financial terms of the transaction were not disclosed.

Agenda Health became involved early in the process, connecting with the owners of A Plus Hospice in the beginning of 2023. According to Spencer Walters, Senior Director at Agenda Health, the firm facilitated the transaction by identifying strategic buyers aligned with the sellers’ goals.

“Agenda Health established a relationship with the owners of A Plus Hospice in early 2023 as they began considering their options for an exit,” Walters said.

Initially, the owners were hesitant to sell due to their deep commitment to the Reno, Nevada community, patients and staff. However, Agenda Health’s structured outreach identified Eden Health as an ideal buyer, thanks to its regional expansion strategy and cultural alignment with A Plus.

“An introductory call quickly revealed strong cultural alignment and mutual transaction benefits, particularly considering both agencies’ existing state provider credentials,” Walters added.

“The deal exemplified an ideal market consolidation, where the owners achieved an ideal exit strategy while Eden Health expanded its regional footprint with a culturally compatible, clinically strong platform,” Walter said, highlighting the deal’s strengths. “The transaction’s attractiveness stemmed from several critical factors: the seamless cultural alignment between organizations, robust employee retention rates, and the operational efficiencies inherent in executing an acquisition within Nevada’s regulatory framework.”

For Eden Health, A Plus Hospice’s strong reputation and outcomes made it an “easy” decision.

“A Plus has a phenomenal reputation in the Northern Nevada market,” said Jamie Brown, COO of Eden Health. “Not only are the staff great, but they also have great outcomes as evidenced by their results on Care Compare, which align greatly with Eden Hospice’s current standings.”

Brown emphasized that the hospice required minimal operational adjustments post-acquisition, which further streamlined the process. The target was performing “extremely well, both clinically and financially,” before the deal, Brown shared.

Integration has been smooth, thanks to Eden Health’s established presence in Northern Nevada.

“We are folding in all of the staff and referral sources into our existing operation,” Brown noted. “Even though it has only been a couple of weeks since the official transition, it has gone very smooth.”

The acquisition aligns with Eden Health’s broader strategy of expanding its hospice footprint through start-ups and acquisitions.

“This acquisition puts us in a great place from a volume perspective, as well as expanding our current footprint in the Northern Nevada market,” said Brown.

However, challenges remain in the hospice sector, particularly around reimbursement rates.

“Reimbursement is the greatest threat to Hospice,” Brown explained.

Labor costs are rising faster than reimbursement rates, particularly in regions like Northern Nevada, which saw a slight decrease in Medicare reimbursement this fiscal year. Eden Health is actively working to navigate these pressures while maintaining high-quality care.

Eden Health’s acquisition of A Plus Hospice reflects broader trends in the Home Health & Hospice (HH&H) sector. According to data captured in the LevinPro HC database, there have been 86 HH&H transactions announced through November 2024. Out of the total deals announced through October, 16 specifically focus on the home hospice and palliative care sector, making up nearly 19% of all HH&H deals during that time and indicating strong interest in the subspecialty. This marks an increase in home hospice and palliative care transactions compared to 2023, when 11 such deals were announced, even as total HH&H dealmaking declined slightly year over year.

In fact, 2024 represents the slowest year for HH&H dealmaking since 2018, when 84 deals were announced between January and November. By comparison, activity peaked in 2021 with 146 deals during the same time frame and has gradually slowed in subsequent years. While overall deal volume has decreased, the consistent representation of home hospice and palliative care transactions underscores the sector’s resilience and growing specialization within the broader market. Despite challenges such as rising labor costs and reimbursement pressures, the hospice sector continues to demonstrate significant activity and consolidation. Deals like Eden Health’s acquisition of A Plus Hospice highlight how providers are leveraging M&A to build scale and maintain competitiveness in increasingly challenging markets.

Check out our other interviews conducted with the Agenda Health team: