Home Health Index | 2016 March 1st Update

The Stoneridge Partners Home Health Index Increases 1.51%

The Stoneridge Partners Home Health Index (HH Index) is up February over January 1.5% but still down YTD 7.51%. The HH index is up 12.35% for the trailing 12 months and 67.24% over the trailing 24 months.

Notably, the S&P 500 increased 7.8 points over the last month, still down 95.89 points YTD. The S&P still has a gain of 88.6 points over a twenty-four month period, but its twelve month performance is a loss of 156.45 points.

The biggest change among our HH Index stocks was seen by AMED, which had a increase of 2.45 points or 6.41%. 

Addus (which does not derive much of its revenue from Medicare) increased 2.2 points or 9.4%.

The record high of 42.55 for our HH Index was set in August.  We are now off over 12.3% from that high.

Quote of the Month:

“Let me conclude by saying that despite the 2016 reimbursement reductions we noted in the release, we have some meaningful payout wins that support our growth expectations for 2016. On a longer term basis, we believe that we are well-positioned to continue gaining market share as a result of the transition to value-based payments. We believe payers and providers will seek the partner with high-quality non-acute care providers that also have the scale, market density, technological sophistication and financial strength to meet their evolving needs.”

CEO of LHC Keith Myers 

-From LHC Q4 2015 earnings call transcript

See It to Believe It!

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

  • Almost Family (AFAM)
  • LHC Group (LHCG)
  • Amedisys (AMED)

Please note the graphs representing (1) HH Index to the percentage change in the S&P 500 Index for over 14 years, (2) 12 month trailing chart of the HH Index, and (3) HH Index to the price of Addus stock (non-Medicare) can be found in the most recent issue of the Home Health Index.


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

Company 2/29/16 1 mos change YTD change 2/28/15 2/28/14
Almost Family 38.58 +0.88% +0.92% 35.62 27.42
Amedisys 38.20 +6.41% -2.85% 30.17 16.96
LHC Group 36.84 -2.93% -18.66% 33.80 23.56
HH Index* 37.87 +1.51% -7.51% 33.20 22.65
S&P 500 1,948.05 +0.40% -4.69% 2104.50 1859.45
Addus 23.41 9.40% +0.56% 21.90 28.76

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)) 3/1/2016 2/1/2016 1/1/2016 12/1/2015 11/1/15 10/1/15
Almost Family 456 453 453 493 430 462
Amedisys 1330 1,250 1,370 1,418 1,390 1,345
LHC Group 693 712 845 867 832 827
HH Index Total 2479 2,415 2,668 2,778 2,652 2,634
Addus 246 221 245 239 236 303

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

Company 3/1/16 2/1/16 2/1/15 2/1/14
Almost Family 89% 89% 71% 73%
Amedisys 108% 101% 88% 39%
LHC Group 90% 92% 85% 39%
HH Index Average* 96% 94% 83% 62%
Addus 74% 66% 77% 87%

Multiples of EV/EBITDA.

Think of this as selling price as a multiple of EBITDA.

Company 3/1/16 2/1/16 2/1/15 2/1/14
Almost Family 12.44 12.35 15.22 11.28
Amedisys 14.92 14.00 20.32** 9.79
LHC Group 8.94 9.19 10.56 7.38
HH Index Average* 12.09 11.85 14.38 8.88
Addus 10.28 9.27 11.57 11.57

*Included Gentiva prior to its acquisition in February 2015 by Kindred.

**The spike in multiple of EBITDA for Amedisys may have been the result of increased earnings announced around that time. It seems that stock trades on current earnings but multiple of EBITDA is calculated on a trailing twelve months.

The above calculations are based on selling price being defined as Enterprise Value (EV), with data provided by Capital IQ.   EV has been calculated based on stock prices September 1. 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 that may differ from that used by a company its reporting.

AFAM in the News

March 3, 2016 Almost Family shares shot up 7% after earnings beat.

LHC Group in the News

“LHC announced what it’s calling an “unprecedented pipeline” in the year ahead… LHC group is actively discussing 20 potential acquisitions in 2016 that could produce approximately $1 billion in revenue…” as reported in Home Health Care News, by Kourtney Liepelt.

Sold!

SOLD BY STONERIDGE PARTNERS!

Cooper, Texas:   Cooper Home Health, a Medicare certified agency, sold to a regional home health company.  Stoneridge Partners provided sell side advisory services.

Belleville, Illinois: BarberVoss Home Care, a non-medical home care provider, sold to a regional health care provider. Stoneridge Partners provided buyside advisory services.

OTHER SALES FROM AROUND THE COUNTRY!

Cincinnati, Ohio: Home Helpers Franchising, Inc., an in-home senior care franchiser with operations in 42 states, sold to private equity firm Linsalata Capital Partners.

Exclusively Listed for Sale by Stoneridge Partners:

  • Florida – Just under $2 million accredited Medicare home health agency in District 8. Stoneridge File SBA-5224
  • Texas – $4.9 million well established Medicare provider in the Dallas/Ft. Worth metroplex. Deficiency free and showing positive growth. Stoneridge File SJL-4918
  • Tennessee – CON for 5 counties in Southeastern TN. Estimated service area of more than 530,000 people with over 87,000 who are older than 65. Rare opportunity to establish or expand services in populous CON. Stoneridge File SBA-6338
  • Alabama – CON for 7 counties in Northeastern AL. Estimated service area of more than 550,000 people with over 91,000 who are older than 65. Rare opportunity to establish or expand services in populous CON. Stoneridge File SBA-6777
  • North Carolina – Accredited $2 million North Carolina Innovations Waiver Provider for Individuals with I/DD located in Winston-Salem and surrounding areas with a strong reputation in the community. Stoneridge File SBA-4001
  • Florida – Accredited Medicare Home Health Agency with approx. $3 million revenue, 98% of which comes from traditional Medicare.  Very profitable, well established agency in Pinellas County.  Stoneridge File SDC-5218
  • Pennsylvania – $4+ million hospice located in Western Pennsylvania. Stoneridge File SBA-5001
  • Mid-Atlantic region – $30 million Medicare/Medicaid agency with multiple branches in several states, including CON service areas. Long history and great reputation for quality care. Stoneridge File SBB-8300 ON CONTRACT
  • Ohio –  $4+ million Medicare/Medicaid agency located in NE Ohio. Stoneridge File SBA-8002
  • California – Approximately $8 million private duty home health and staffing company located in Northern California with multiple locations. Stoneridge File SBA-7500
  • California – $2.5 million private duty home care company located in Northern California. Motivated seller. Stoneridge File SBA-1572
  • North Carolina – Accredited $2 million North Carolina Innovations Waiver Provider for Individuals with I/DD located in Winston-Salem and surrounding areas with a strong reputation in the community. Stoneridge File SBA-4001
  • New York and New Jersey – Approximately $3 million private pay agency. Licensed in the 5 Boroughs of NY and the entire state of NJ with current operations predominantly in Central NJ. Stoneridge File SBA-8015
  • New Jersey $3.5 million Medicaid agency in Northern NJ. Great opportunity for existing operator to add revenue and service area. Motivated seller. Stoneridge File SBB-9254
  • Minnesota – $14 million revenue Medicare certified home health agency with large Medicaid census, well established and deficiency free, SE Minnesota. Stoneridge File SJL-5268
  • Pennsylvania – Approx. $4 million Medicaid home care agency located in central PA. Accelerated and profitable growth trajectory with continued opportunity for future growth. Professionally run with outstanding clinical and excellent staff in place.  Stoneridge File SBA-1000. ON CONTRACT
  • Colorado – $2.5 million diversified home care agency  and hospice,  accredited with excellent books and records.  Stoneridge File SJL-1005
  • Rhode Island – $2.5 million Medicare agency.  Accredited in CON state.  Stoneridge File SBB-1100
  • Texas – $4.8 million Medicare agency in Houston metro area with solid bottom line. 65% of revenue from traditional Medicare and the balance in private non-skilled care. Stoneridge File SJL-2000
  • Oklahoma –  $1.5 million Medicare agency.  89% of revenue from traditional Medicare.  Stoneridge File SJL-4131
  • Florida – $4 million in pure private pay.  15% bottom line.  Accredited on the central east coast.  Stoneridge File SDC-3250
  • Illinois – $5 million plus Medicare agency with four offices. Strong management with excellent clinical.  Stoneridge File SBB-6550
  • Texas – $4 million East Texas Medicare certified home health agency with diverse payor sources, including Medicare, Medicaid, pediatric and private pay.  Stoneridge File SJL-3665
  • Massachusetts – $5 + million home health agency, primarily Medicaid, but also private pay and commercial insurance, plus Medicare certification. Zero deficiencies on last survey.  Stoneridge File SBA-9300. ON CONTRACT
  • Florida – $5 million Medicare agency located in the Tampa – St. Pete area.  Accredited, with solid bottom line.   Stoneridge File SBA-4109. ON CONTRACT
  • Texas – $1.5  million East Texas Medicare certified home health agency, providing skilled care, approx 75% from traditional PPS Medicare.  Last survey was deficiency free. Stoneridge File SJL-4088
  • Texas – $2.3 million Medicare certified home health agency in Houston, Texas. 92% Traditional Medicare. Stoneridge File SDC-1542
  • Texas – $3.3 million accredited Medicare home health agency. Profitable and still growing with approximately 87% of revenue coming from traditional Medicare. Strong marketing team in place with diversified referral sources. Stoneridge File SJL-1500. ON CONTRACT
  • Texas – $2 million Fort Worth Medicare agency, approx 90% traditional Medicare. Stoneridge File SJL-2650. ON CONTRACT
  • Ohio – $2.5 million Medicare agency in Columbus area, 75% traditional Medicare, long history of quality care.  Stoneridge File SRG-5232
  • Texas – $1 million Medicare agency in the DFW area – 99% of revenue from traditional Medicare.  Stoneridge File SJL-1015

To see more home care agencies and hospices exclusively listed for sale by Stoneridge Partners go to the following link: Agencies for Sale

Do you know of any acquisitions that have taken place?  We would be interested in your comments.  At the top of this column is a “Contact Tab” with a section for comments.  These can be sent anonymously. The return email address can be left blank.  We are interested in what you have to say, or acquisitions that you know about.

Another favorite from The New Yorker

http://www.technologyinvestor.com/wp-content/uploads/2016/02/LivingLonger.jpg

More

From Rich Tinsley, Publisher of “The Home Health Index” rich@stoneridgepartners.com  1-800-218-3944

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: Almost Family | Amedisys | LHC Group