UnitedHealth Group Acquisition of Amedisys Under Fire by DOJ

by Kristin Rowan, Editor

Justice Department Sues

In September of 2023, UnitedHealth Group made a bid to purchase Amedysis. That acquisition has been under scrutiny since last year. When the bid was announced, the Department of Justice began an inquiry, asking for additional information. At the time, Amedysis indicated that they anticipated the inquiry.

Now, more than a year later, the Department of Justice, along with the Attorneys General of Maryland, New York, New Jersey, and Illinois, have filed an antitrust lawsuit to block the acquisition. The proposed $3.3 billion acquisition would eliminate competition between the two companies. It would also give too much control to UnitedHealth Group, according to the suit.

Statement from the Department of Justice

The DOJ and the Attorneys General stated that the merger is illegal. The two companies own so much of the market share in the space already that combining the two would mean less choice for patients and fewer employment options for nurses seeking competitive pay and benefits. 

UnitedHealth Group already acquired Amedisys’s biggest home health and hospice rival, LHC Group. Since that acquisition, UnitedHealth Group and Amedisys have been two of the largest providers of home health and hospice care in the United States.

DOJ Blocks United Amedisys

American healthcare is unwell. Unless this $3.3 billion transaction is stopped, UnitedHealth Group will further extend its grip to home health and hospice care, threatening seniors, their families and nurses.

Jonathan Kanter

Assistant Attorney General, Justice Department anti-trust division

Surprisingly, the former CEO and current board chairman of Amedisys acknowledged the problems. He said that the competition between the two companies has helped keep them honest. He also said it has driven better quality to the benefit of their respective patients. The former CEO went on to say that the companies also compete for nurses and the merger may threaten the benefits nurses receive. It seems even the heads of the companies involved know this is a bad idea.

UnitedHealth Group's Proposed Solution

In response to the concerns voiced by the DOJ, UnitedHealth proposed to divest some of its facilities to VitalCaring Group. UnitedHealth said this would prevent the monopoly the merger creates. The DOJ responded to that proposal somewhat harshly.

The complaint alleges that the UnitedHealth Group’s market share would be illegal in home health markets in 23 states and the District of Columbia. It would also be illegal in hospice markets in 8 states, and in the nurse labor market in 24 states.

UnitedHealth’s proposed divestiture would only alleviate the monopoly in a few areas. This leaves hundreds of markets across the U.S. in jeopardy. Further, VitalCaring Group has poor quality scores and is facing its own legal judgement of close to half a billion dollars. Allegedly, the current CEO of VitalCaring Group was the CEO of a competitor while running VitalCaring behind the scenes.

Good News for Home Health and Hospice

The complaint describes home health and hospice services as “critically important parts of the American healthcare system….Patients rely on the skill and expertise of home health and hospice nurses, who must effectively treat patients at home.

Millions of patients depend on United and Amedisys to receive home health and hospice care in the comfort of their homes. The Department’s lawsuit demonstrates our commitment to ensuring that consolidation does not threaten quality, affordability, or wages in these vital healthcare markets.

Benjamin C. Mizer

Principal Deputy Associate Attorney General

Attorney General Merrick B. Garland said, “We are challenging this merger because home health and hospice patients and their families experiencing some of the most difficult moments of their lives deserve affordable, high quality care options. The Justice Department will not hesitate to check unlawful consolidation and monopolization in the healthcare market that threatens to harm vulnerable patients, their families, and health care workers.”

Final Thoughts

Mister Attorney General, please turn your attention to CMS and Medicare Advantage, as they continue to threaten the safety and well-being of patients, families, and caregivers with increasingly low reimbursement rates and denials of coverage.

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Kristin Rowan, Editor
Kristin Rowan, Editor

Kristin Rowan has been working at Healthcare at Home: The Rowan Report since 2008. She has a master’s degree in business administration and marketing and runs Girard Marketing Group, a multi-faceted boutique marketing firm specializing in event planning, sales, and marketing strategy. She has recently taken on the role of Editor of The Rowan Report and will add her voice to current Home Care topics as well as marketing tips for home care agencies. Connect with Kristin directly kristin@girardmarketinggroup.com or www.girardmarketinggroup.com

©2024 by The Rowan Report, Peoria, AZ. All rights reserved. This article originally appeared in Healthcare at Home: The Rowan Report. One copy may be printed for personal use: further reproduction by permission only. editor@therowanreport.com

The Great Hospital/Home Health Divorce Movement

by Tim Rowan, Editor Emeritus

Hospitals Divesting Home Health Departments

Is this an early omen of two related trends? A number of hospitals are divesting their home health departments, while large health insurance companies are swallowing up large home health companies.

Beckers reported on October 23 that Providence Health plans to spin off its home-health services along with hospice and palliative care into a new joint venture that will be managed by Compassus, a for-profit, Tennessee-based provider of home care services in 30 states. The move will affect about 700 patients receiving care every day in Spokane County.

The Catholic not-for-profit health system’s agreement with Compassus will be known as “Providence at Home with Compassus.”

After a regulatory review, the deal is expected to close in early 2025. Providence and Compassus will each own a 50% stake. The new venture is part of a strategy to expand and improve home-based services, but also to cut costs. Providence, which operates Sacred Heart Medical Center and Holy Family Hospital in Spokane, declined to disclose the financial details of the joint venture.

LHC Group Was Not Enough

A news release that surfaced on October 25 said that UnitedHealth Group representatives are set to meet with Justice Department officials to make the case for the insurance giant’s acquisition of Amedisys to be approved. The meeting is often the last step before the Justice Department decides whether to file a lawsuit challenging an acquisition, according to the news outlet

Amedisys operates more than 500 facilities in 37 states. Shareholders approved the acquisition in September 2023, but the deal has been held up by regulatory scrutiny. Justice Department officials are concerned the deal could increase prices for home health, according to Bloomberg. 

Hospitals Divesting Home Health

If approved, this would be phase two of UnitedHealth’s historic foray into our sector. United acquired LHC Group, a home health provider with more than 900 locations, in February 2023. If UnitedHealth’s acquisition of Amedisys is approved, the company would own 10% of the entire home health market, with significant overlap between Amedisys and LHC acquisitions in some Southern states, according to Bloomberg. 

Regulators could approve the deal with some changes to address competition concerns, Bloomberg reported. In August, Amedisys and UnitedHealth agreed to sell a reported 100 home health and hospice care centers to VitalCaring Group if the merger is approved.

Three or More is a Trend

UnitedHealth is not the only insurance company interested in owning home health agencies and hospices:

  1. Humana acquired Kindred, one of the nation’s largest HHAs, and rebranded it CenterWell Home Health. Today it operates more than 360 home health locations in 38 states. In 2023, the company said it would expand into in-home primary care in several states.
  2. In 2023, CVS Health acquired home health provider Signify Health for $8 billion. The company won a bidding war for Signify over UnitedHealth Group, Amazon and Option Care Health. Signify Health has more than 10,000 clinicians.
  3. Evernorth, Cigna’s health services arm, offers home health services with a staff of more than 430. In January, Cigna CEO David Cordani said home health was one area where it would focus on future acquisitions.
  4. In 2021, Centene sold its majority stake in home-based primary care provider U.S. Medical Management. Centene retained a minority stake in the company.

Our healthcare sector is changing as the entire U.S. healthcare scene changes. Next week we will delve further into the ramifications of the CMS 2025 final rule and of course the political events of this week.

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Tim Rowan, Editor Emeritus
Tim Rowan is a 30-year home care technology consultant who co-founded and served as Editor and principal writer of this publication for 25 years. He continues to occasionally contribute news and analysis articles under The Rowan Report’s new ownership. He also continues to work part-time as a Home Care recruiting and retention consultant. More information: RowanResources.com
Tim@RowanResources.com

©2024 by The Rowan Report, Peoria, AZ. All rights reserved. This article originally appeared in Healthcare at Home: The Rowan Report. One copy may be printed for personal use: further reproduction by permission only. editor@therowanreport.com

BREAKING NEWS – HHAeXchange Acquires Sandata

HHAeXchange Acquires Sandata

FOR IMMEDIATE RELEASE

Contact:                                       Michelle Rand
Alloy on behalf of HHAeXchange
855-300-8209
hhaexchange@alloycrew.com

HHAeXchange Acquires Sandata Technologies, Enhancing Ability to Serve Homecare Providers, Payers, and Caregivers Nationwide

Best positioned to deliver transformative technology that accelerates the industry’s evolution and its ability to improve health outcomes

NEW YORK and PORT WASHINGTON, N.Y., Oct. 03, 2024  — HHAeXchange, a leader in homecare management solutions for providers, caregivers, managed care organizations (MCOs), and state Medicaid programs, today announced that it has acquired Sandata Technologies. With four decades of experience, Sandata provides solutions that serve the homecare industry. Together, HHAeXchange and Sandata are well-positioned to meet the growing need for home and community-based services (HCBS), with demand for personal care aides expected to rise by 43% between 2020 and 2035.

From HHAeXchange

We are excited to join forces with Sandata, who shares our commitment to enabling homecare stakeholders to deliver the highest quality of care to their members,” said Paul Joiner, Chief Executive Officer of HHAeXchange. “This acquisition further demonstrates our commitment to investing in and raising the bar for our customers, while leading the transformation of an industry that deserves best-in-class technology and a superior experience. We will leverage our expanded platform by innovating with states and health plans to enable providers and better health outcomes. By doing so, we will further empower the devoted caregivers who are at the heart of our industry.”

“Now is the time to harness the power of advanced technology to truly support providers and payers with their billing needs and compliance requirements – and ultimately, deliver on the promise of our industry.”

Paul Joiner

Chief Executive Officer, HHAeXchange

From Sandata

“For decades, Sandata has been dedicated to ensuring providers and payers can seamlessly work together to increase compliance, improve efficiency, and deliver high-quality care,” said Sandata’s Chief Executive Officer, Emmet O’Gara. “Joining HHAeXchange strengthens our commitment and represents an exciting new chapter for Sandata, positioning the new combined company for continued growth and innovation by enhancing the value we can deliver to our customers.” 

HHAeXchange Acquires Sandata

HHAeXchange’s transaction with Sandata builds on the company’s recent strategic acquisitions of Cashé and Generations. These investments collectively support HHAeXchange’s ongoing advancement of its mission to enable caregivers, families, providers, and payers to deliver the best care in the home. Paul Joiner, HHAeXchange’s CEO, will lead the combined business moving forward.

Financial terms of the transaction were not disclosed.

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About Sandata

Sandata, now part of HHAeXchange, is the pioneering force in home and community-based care, consistently leading the way with innovative technology solutions. As a trusted leader, Sandata is deeply committed to addressing critical challenges in the sector by expertly connecting the homecare ecosystem. This commitment creates a positive and lasting impact on payers, providers, caregivers, and those who receive care.

Sandata’s industry-leading software, systems, and services optimize billing and claims processing for payers, streamline administrative processes for providers, and facilitate better experiences for caregivers and those who receive care. Sandata’s vision and commitment to transforming the industry continue to shape the future of care at home and in our communities, ensuring better outcomes for all involved.

About HHAeXchange

Founded in 2008, HHAeXchange is the leading technology platform for homecare and self-direction program management. Developed specifically for Medicaid home and community-based services (HCBS), HHAeXchange connects state agencies, managed care organizations, providers, and caregivers through its intuitive web-based platform, enabling unparalleled communication, transparency, efficiency, and compliance. For more information, visit hhaexchange.com or follow the company on TwitterLinkedIn and Facebook.

This information originally appeared on the HHAeXchange website and it reprinted with permission.