by Rowan Report | Mar 7, 2025 | Partner News
PEAK ROCK CAPITAL AFFILIATE COMPLETES ACQUISITION OF BRIGHTSTAR CARE
Firm continues to invest in high-growth healthcare and franchisor businesses
AUSTIN, Texas, March 3, 2025 – An affiliate of Peak Rock Capital (“Peak Rock”), a leading middle-market private equity firm, announced today that it has completed the acquisition of BrightStar Group Holdings, Inc. (“BrightStar Care,” or the “Company”) in partnership with the Company’s founder, Shelly Sun Berkowitz.
Founded in 2002, BrightStar Care is a leading franchisor of home care services with over 400 agencies nationwide. The Company’s franchisees provide both skilled and unskilled home care to clients and custom medical staffing solutions to corporate partners. BrightStar Care stands out for its reputation of excellence and ability to maintain a support system for new and existing franchisees to build long-term success. The Company also holds national accounts with corporations and other partners across distinct patient populations providing healthcare staff anywhere it is needed. BrightStar Care franchisees are committed to providing the highest standard of care through their clinical nurse-led care model. Network-wide, the agencies are Joint Commission accredited, which is the nation’s oldest and largest standards-setting and accrediting body in healthcare.
Spencer Moore, Managing Director of Peak Rock, said, “BrightStar Care stands out because of its unique commitment to clinically led, high quality home care services across its franchisee network. We are excited to partner with Shelly and BrightStar Care management and employees to invest in technology, marketing, and growth initiatives to support the Company’s franchisees in serving more patients.”
“I believe our partnership with Peak Rock will help BrightStar Care continue its mission of providing clients with high-quality compassionate care in the home, as well as make investments to facilitate continued growth with existing and new franchisees. I am looking forward to working with the Peak Rock team during the Company’s next stage of growth.”
Founder and Executive Chairwoman, BrightStar Care
“We have found a strong partner in Peak Rock Capital, a group aligned with BrightStar Care’s mission and vision for the future,” said BrightStar Care CEO Andy Ray. “With Peak Rock Capital, BrightStar Care will broaden access to high-quality care for more families, making key investments as we continue to lead the industry.”
Anthony DiSimone, Chief Executive Officer of Peak Rock, added, “This transaction demonstrates Peak Rock’s commitment to investing in founder-owned businesses with strong growth potential. It also highlights our continued interest in investing in resilient healthcare businesses and franchisors that will benefit from our expertise in supporting rapid growth.”
JP Morgan and Boxwood Partners served as the financial advisors and Latham & Watkins served as legal counsel to BrightStar. Lincoln International served as the financial advisor and McDermott Will & Emery served as legal counsel to Peak Rock.
About BrightStar Group Holdings, Inc.
Founded in 2002, BrightStar Care is a leading franchisor of home care services with more than 400 franchised locations nationwide that provide skilled and unskilled home care to clients and custom medical staffing solutions to corporate entities. Their franchise agencies across the country employ more than 15,000 caregivers and 5,700 registered nurses who oversee the care and safety of each individual client. Franchisees are committed to providing a higher standard of care through their clinical nurse-led care model. Network-wide, the Joint Commission accredited BrightStar Care agencies. Joint Commission is the nation’s oldest and largest standards-setting and accrediting body in healthcare. BrightStar Care has also consecutively received The Joint Commission Enterprise Champion for Quality award for more than a decade. For further information about BrightStar Care, please visit www.brightstarcare.com.
Peak Rock Capital is a leading middle-market private investment firm that makes equity and debt investments in companies in North America and Europe. Their equity investment platform focuses on opportunities where it can support senior management to drive rapid growth and profit improvement, with expertise in corporate carve-outs and partnering with families and founders seeking first-time institutional capital. The credit platform invests across capital structures, with a broad mandate to provide flexible, tailored capital solutions to middle-market and growth-oriented businesses. Peak Rock’s real estate platform makes equity and debt investments in small to mid-sized real estate assets in attractive, growing geographies. For further information about Peak Rock Capital, please visit www.peakrockcapital.com.
©2025. This press release originally appeared on prnewswire. For additional information, please see the contact information above.
by Kristin Rowan | Nov 15, 2024 | Clinical
Will the Change in Leadership Usher in a Change in Reimbursement Rates?
As in any election year, we have been bombarded with promises, predictions, and pandering from senate and house hopefuls as well as presidential candidates from every party. Each of them found platform issues that resonated with their followers. In turn, they have accused their opponents of all manner of sin.
Now that the election has passed and the lame duck session of congress has begun, analysts have started looking to January and how election results may impact different industries. Analysts believe Trump, along with congressional Republicans, will aggressively push Medicare Advantage. One researcher predicts that traditional Medicare will “wither on the vine.”
Opposition to our current health care and insurance system often advocate for a single-payer system that is seen in places like England and Canada. Naysayers refer to this as the “socialization” of medicine, referring to socialist and communist governments. Privatization, on the other hand, moves healthcare out of the hands of the government and into the hands of privately held, usually for-profit, health insurance companies. Medicare Advantage has quietly moved more than 50% of all Medicare eligible patients to a privatized system. Senior policy analyst at Paragon Health Institute, Joe Alabanese believes that the Trump administration and a republican Congress would be “more friendly” to the idea of privatized health care.
Whether the stock prices just before and after election day are predictive of things to come remains to be seen. For now, the information before us is this:
-
- Between Nov 1 and Nov 7, Humana Inc. had the largest increase in stock prices at 10.7%
- UnitedHealth Group Inc. rose 5.1% in the same time period
- Both companies had greater stock increases than the average across S&P
- Elevance Health was in keeping with the rest of the S&P with an increase of 3.6%
- Molina Healthcare, Inc. and The Cigna Group dropped 0.2% and 0.4%, respectively
Analysts say the jumps are in keeping with expectations that Republican control in Congress and in the White House will be beneficial for Medicare Advantage
It’s no secret that The Rowan Report is not a fan of Medicare Advantage. Specifically, the sales tactics used on the elderly and infirmed are predatory and the denial rate is criminal. The more eligible patients sign up for Medicare Advantage the less they will receive the care they need. Further, the more Medicaid has to supplement the cost of Medicare Advantage, the more home care agencies will suffer. Nationally, the more CMS regulates payment rates, pre-authorizations, and denial rates by privatizing Medicaid, the worse off our entire healthcare system will be.
With the state and national associations, we will continue to advocate on behalf of care at home agencies and their patients. And we hope you will too, regardless of who is in office. We have support at the federal level and we will continue to fight the good fight.
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
by Kristin Rowan | Oct 18, 2024 | CMS, M&A, Medicare Advantage, Regulatory
UnitedHealth Group Earnings Show Strong Q3 Revenue Growth
For most of 2024, and even going back into 2023, The Rowan Report has written about UnitedHealth Group and its acquisitions, its over diagnosing patients for financial gain, its dropping of Medicare Advantage plans, and, of course the Change Healthcare cyberattack.
Despite all the negativity, UnitedHealth Group continues to grow. The company’s revenue grew more than 9% over last year’s Q3 numbers. Even after the cyberattack, Optum grew by more than $2 billion. According to UnitedHealth Group CFO John Rex, the growth is due to an increase in both the number and type of care services offered. Optum operates three subsidiaries, OPtum Health, OptumRx, and OptumInsight, with total revenue of $63.9 billion.
CyberAttack did not Impact Earnings
According to the Q3 financial statement, per share earnings of $6.51 include the cyberattack impacts. The annual adjusted net earnings outlook for 2024 is between $27.50 and $27.75, in line with earlier projections. The 2024 net earnings outlook reflects both the selling of South American properties and the impacts from the Chnage Healthcare cyberattack. Net earnings outlook is $15.50 to $15.75 per share.
More UnitedHealth Group Acquisitions on the Horizon
UnitedHealth Group CEO Andrew Witty said the company is using a five pillar growth strategy. They will continue to spend money acquiring companies for United Healthcare, value-based care, pharmacy businesses, financial services, and what he called “technology-ed opportunities.
While UnitedHealth Group and Optum post higher revenue and cash flow and their shareholders se an increase in per share earnings, subscribers to UnitedHealth insurance plans are losing. Monthly premiums and annual deductibles for Medicare Part B increased from 2023 to 2024. Part B standard premiums are expected to increase by almost 6% in 2025. For seniors with higher income, the adjustment amount will go up to $74 per month, making monthly premiums jump to $259. The base beneficiary premium for Part D also increased in 2024 and will again for 2025.
Effective September 1, 2024, UnitedHealthcare started requiring prior authorization for Medicare Advantage member to receive PT, OT, and ST services when performed outside of the home. Not surprisingly, United Health owns multiple practices that offer PT, OT, and ST at home. Those services don’t require prior authorization. UnitedHealth Group is enjoying higher revenue, higher net income, and is funneling the money from insurance premiums back into its own pocket.
This announcement came just after UHC announced a gold card program to reduce prior authorization requirements. The gold card program started October 1st and was supposed to reduce the prior authorization request volume for provider groups. Providers groups who are in-network, have a minimum number of prior authorizations for two years, and have at least a 92% approval rate qualify for gold status.
Home health agencies are struggling to survive with lower payment rates from Medicare plans and operating in the negative under Medicare Advantage plans. Physician practices, surgery centers, urgent care, and pharmacy benefit managers are operating under UHC for even greater profits. More patients are seeing delays in care due to increased prior authorization requirements, unless the patient is seeing a caregiver owned by UHC. Shareholders are getting increased per share revenues. Perhaps there’s a solution hidden in the math there somewhere.
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
by Kristin Rowan | Oct 18, 2024 | M&A, Vendor Watch
The Future of HHAeXchange
Earlier this month, we announced that HHAeXchange acquired Sandata. This announcement came not long after the announcements that they had acquired Cashé and Generations. Last week, The Rowan Report sat down with Stephen Vaccaro, President of HHAeXchange to talk about this latest acquisition and what it means for HHAeXchange going forward.
Stephen Vaccaro: On the Record
The Rowan Report:
Stephen, thank you for meeting with me today. I’m sure you are quite busy with this latest news. What can you tell us about the acquisition of Sandata?
Stephen Vaccaro:
We’re very excited about all of the changes we’ve made this year. We were excited about Cashé and Generations, and we’re excited about Sandata. Sandata is larger, in scale, than the other two. They operate at the state level, in managed care, and with providers.
RR:
How will this acquisition impact what HHAeXchange is doing?
Stephen:
HHAeXchange recognized the need for more standardization in the industry. It’s been so fragmented for so long. We need better data and better insights to deliver better care. The combined footprint of HHAeXchange and Sandata puts us in the position to deliver on that.
RR:
What immediate changes should we expect to see?
Stephen:
Sandata as a brand will continue to exist, just under the HHAeXchange brand now. We have no plan to make any changes to the technology or the teams. We’ve spoken to the state and managed care clients and they are excited about this as well. They will continue working with the teams they know and the technology they know.
RR:
Do you anticipate more changes down the road?
Stephen:
Over the next six to twelve months, we will evaluate the technology to assess where it can be put to best use. We expect to see some thoughtful consolidations that are well thought out and communicated to all. We have no plan to get rid of Sandata or make anyone leave the platform. As we are consolidating these technologies, we’re taking the expertise of each of these great organizations into one integrated platform. We think what you’ll see is the new standard for homecare management, driving innovation and efficiency across the industry. This, in turn, helps deliver better care in the home.
RR:
I spoke with Paul Joiner, HHAeXchange CEO, after the acquisition of Cashé and Generations. At that time, he told me that those acquisitions were part of a larger strategy that comes with a bigger reveal. Now that the big reveal has happened, what can you tell us about the future of HHAeXchange?
Stephen:
We are focusing on operational efficiency so caregivers can focus on care and better outcomes. The message we want to share is that we are ensuring that there’s flexibility, inclusiveness, scalability within homecare management solutions to any stakeholder. We will never be the single solution for everyone, but we aim to be the best solution to adapt to regulatory changes and emerging trends and make sure that we’re building trust and confidence and demonstrate the commitment that we’re making to ensure best in class software. We believe the path we’re on is transformative for the industry.
RR:
It sounds like there may be more announcements in the future. I’m excited to see what you do next. Thank you for talking with The Rowan Report.
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
by Rowan Report | Jun 21, 2024 | M&A, Partner News, Vendor Watch
HHAeXchange Acquires Cashé Software, Strengthening Homecare Operations for Thousands of Agencies and Individuals
Acquisition secures expanded access to solutions that enable caregivers, families, providers, and payers to deliver the best care in the home
NEW YORK, June 18, 2024 – HHAeXchange, a leader in homecare management solutions for providers, managed care organizations (MCOs), state Medicaid agencies, and fiscal intermediaries, today announced its acquisition of Cashé Software, a leading Minnesota-based solution for homecare operations and billing. The strategic transaction brings together two premier, complementary providers of end-to-end homecare software platforms, significantly expanding the combined company’s ability to help thousands of homecare providers and payers across the U.S. ensure compliance, streamline billing, and optimize workforce management.
The homecare industry continues to experience rapid growth, and is expected to increase from $100 billion in 2024 to $176 billion by 2032. Software that streamlines operations and enables agencies to achieve better health outcomes will play a key role in this projected growth, as home and community-based services (HCBS) providers increasingly turn to such tools to manage all aspects of their agency operations.
“Today marks an exciting milestone as we join forces with Cashé. In addition to its robust product set, the company shares HHAeXchange’s passion for homecare, technology, and innovative software,” said Paul Joiner, HHAeXchange’s Chief Executive Officer. “Homecare agencies need purpose-built technology to support them in delivering quality care. We are thrilled to partner with the Cashé team to collaborate on our vision of delivering the most comprehensive solution that drives operational efficiency, increases compliance, and improves health outcomes.”
Since 2004, Cashé has provided advanced technology and services to simplify and streamline mission critical processes, benefiting more than 400 homecare agencies in Minnesota. With its recent launch of the Pavillio platform, Cashé continues to demonstrate its commitment to helping agencies get paid faster, increase team capacity, eliminate error-prone manual processes, and automate revenue cycle management.
“For 20 years, Cashé has been focused on ensuring our customers can rely on our software to help them deliver the best care in the home,” said former Cashé President Praba Manivasager, who now leads the Cashé business unit at HHAeXchange. “This commitment is strengthened by our partnership with HHAeXchange, and we look forward to working together as a team to accelerate our vision of building the software platform that sets the standard for efficient workflows and insightful data.”
For more information about HHAeXchange, its solutions, or the Cashé acquisition, visit www.hhaexchange.com.
# # #
About Cashé Software
Cashé Software is a leading technology partner for Home and Community-Based Service (HCBS) providers serving the Medicaid aging and disability population. Dedicated to helping agencies implement top operational practices and achieve the highest standards of care, Cashé Software offers end-to-end solutions that have enabled hundreds of agencies automate operations, implement EVV, ensure compliance, and achieve an impressive 99% first-time payment rate on billing. Driven by their mission to positively impact 2 million lives, all of Cashé’s solutions are designed with a person-centered focus to empower the entire care team.
by Rowan Report | May 10, 2024 | M&A
Bon Secours Mercy Health to Outsource Home Health and Hospice to Compassus
Bon Secours Mercy Health (BSMH), the fifth-largest Catholic health system in the U.S., and Compassus, a leading national provider of home-based health care services, announced on May 2 that they have signed an agreement to form a 50/50 joint venture partnership for BSMH home care and hospice. Under the agreement, Bon Secours will outsource to Compassus, who will manage operations for 10 home health agencies and 11 hospice operations spanning five states.
Under the agreement, BSMH will maintain ownership of its existing hospice house real estate assets in specific locations while Compassus will manage the operations. BSMH will work closely with Compassus to support the home health and hospice associates transferring to employment with Compassus. Under the joint venture, the team will continue to provide spiritually grounded care and will operate in accordance with Ethical and Religious Directives.
The agreement is subject to state and federal regulatory review and final diligence; however, the agreement formalizes the intent of both parties to move forward with the transition and integration.
About Compassus
Compassus provides home-based services including home health, infusion therapy, palliative and hospice care. The company’s more than 6,000 team members serve more than 100,000 patients annually across more than 250 locations in 29 states. This is not the company’s first joint venture. In 2020, Compassus became managing partner of Ascension at Home, a joint venture between Ascension and Compassus.
About Bon Secours Mercy Health
Bon Secours Mercy Health (BSMH) is one of the 20 largest health systems in the United States and the fifth-largest Catholic health system in the country. The ministry’s quality
, compassionate care is provided by more than 60,000 associates serving communities in Florida, Kentucky, Maryland, New York, Ohio, South Carolina and Virginia, as well as throughout Ireland.
Bon Secours Mercy Health provides care for patients more than 11 million times annually through its network of more than 1,200 care sites, which includes 48 hospitals. In 2022, BSMH provided more than $600 million dollars in community investments across five states, ensuring that cost is not a barrier to health care for patients in need.
In addition to charity care, BSMH invests in programs that address chronic illness, affordable housing, access to healthy food, education and wellness programs, transportation, workforce development and other social determinants of health. The Mission of Bon Secours Mercy Health is to extend the compassionate ministry of Jesus by improving the health and well-being of its communities and bring good help to those in need, especially people who are poor, dying and underserved. https://bsmhealth.org/
©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
by Kristin Rowan | Feb 14, 2024 | Admin, M&A
By Kristin Rowan, Editor
Home care is no stranger to mergers and acquisitions. It seems there is news almost daily about companies joining forces or selling parts of their company to new entities. Notably, we reported just last week that Cigna has dropped its entire Medicare Advantage book of business. This week, we have two M&A stories to share with you.
Acquisition
Texas-based agency Angels of Care, previously of Varsity Healthcare Partners, has been bought by Nautic Partners, a private equity company. Angels of Care provides pediatric home health, including private duty and skilled nursing services, along with physical and speech therapy, and respite care. Angels of Care operates in seven states, up from two states prior to their partnership Varsity Healthcare Partners, and employs more than 2,000 nurses, physical therapists, and other service providers.
Nautic Partners, based in Providence, RI, is already a backer of VitalCaring Group, a similar agency with locations across the southern United States, Integrated Home Care Services, providers of DME, home care, and infusion services in Puerto Rico, almost 30 additional healthcare companies. Nautic is a middle-market firm founded in 1986. They specialize in healthcare, industrials, and services.
Partnership
CVS’ Aetna has partnered with Monogram Health to offer in-home care services to Medicare Advantage members with chronic kidney disease. Nurses from Monogram will provide in-home and virtual appointments to eligible members. The two companies will also reportedly work to get timely referrals for kidney transplant evaluations.
Monogram Health is a tech start-up for in-home kidney disease management. Their latest growth funding round garnered $375 million in new funding from health care companies and financial backers, including CVS. Monogram has raised a total of $557 million. Monogram operates by creating value-based care deals with health insurance plans and risk-bearing providers to manage chronic and end-stage renal diseases.
If this model sounds familiar to you, it might be because we wrote last week about Gentiva, which is partnering with risk-based providers to offer palliative care services with risk-sharing benefits on both sides. I expect this is not the last time we will hear/write about risk-sharing partnerships to pay for services that aren’t covered by health care plans.
# # #
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.homecaretechreport.com One copy may be printed for personal use: further reproduction by permission only. editor@homecaretechreport.com
