Stoneridge Partners’ Home Health Stocks Start Strong And Post Acute Index Premiere
Home health stocks start strong in 2020
The latest Home Health Index (HHI) from mergers and acquisitions (M&A) advisory firm Stoneridge Partners shows home health stocks have continued their strong performance into 2020, handily outpacing the broader market in January.
The HHI was up nearly 6% in January compared to December 2019. That surge easily bested the S&P 500, which was down slightly — 0.16% — in January compared to the previous month.
January marked the first month home health providers have operated under the new Patient-Driven Groupings Model (PDGM). While the effect PDGM will have across the broader industry is still unclear, early returns seem to indicate that large providers like Amedisys and LHC Group have weathered the initial storm and may be looking for gains in the second half of 2020 as new M&A or patient-acquisition opportunities emerge.
“Small and mid-sized home health businesses may have cash flow challenges come March and April,” Stoneridge Partners President Rich Tinsley said. “That could set up a scenario where bigger players see opportunities for expansion in key markets moving forward, either through direct acquisitions or patient volume growth as competitors leave the market.”
Stoneridge’s HHI tracks the stock values for Baton Rouge, Louisiana-based Amedisys, Inc. (Nasdaq: AMED) and Lafayette, Louisiana-based LHC Group, Inc. (Nasdaq: LHCG). The HHI also follows stock prices for Frisco, Texas-based Addus HomeCare Corporation, but doesn’t include them in its final calculations due to the company’s focus on Medicaid-supported personal care services.
Amedisys stock values were up 5.83% in January compared to December, while LHC Group stocks were up 5.48% during the same period. Addus stock was up 4.25% in January compared to December.
Stoneridge premieres post-acute care index
New for 2020, Stoneridge Partners is rolling out a second index tracking the performance of key publicly-traded post-acute care providers. The new monthly report includes stock values for the companies traditionally monitored by the current HHI and adds results for the Pennant Group, Inc. (Nasdaq: PNTG), Encompass Health Corporation (NYSE: EHC) and Brookdale Senior Living (NYSE: BKD).
The inaugural Post-Acute Care Index shows a mixed bag for providers. As noted above, stock values for Amedisys and LHC Group both climbed in January – and Encompass Health also performed well last month with stock values up more than 10%. Alternatively, The Pennant Group and Brookdale struggled to start off the year, with stock values down 25% and 10%, respectively.
Quote Of The Month
“As we turn the page to a new decade, 2020 will mark a major turning point in not only delivering care but in helping patients achieve greater wellness. Health systems across the world are beginning to take a more dedicated focus on the social determinants of health, the non-medical elements contributing to someone’s health and wellness.” – Adrian Schauer, CEO of cloud-based home care technology provider AlayaCare
Read the Full Article Here: How Technology is Driving Wellness in Home Care
Articles Featuring Stoneridge
Associate Partner Tom Lillis was featured in Home Health Care News on the PDGM impact. Read the full article here: Voices: Tom Lillis, Associate Partner, Stoneridge Partners
CLOSED by Stoneridge
- Partner Joe Lynch represented a Texas-based agency that closed since the last Home Health Index
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)
This graph compares the percentage of the Home Health Index to the percentage change in the S&P 500 Index going back to 2002.
This is a 12 month trailing chart of the HH Index compared to the actual prices of the individual companies that make up the chart.
This graph displays HH Index performance since 2002.
This graph compares the HH Index to the price of Addus stock (non-Medicare).
(Home Health Index February 2020 | Stoneridge Partners)
Here are the results of the stock prices for the past two years:
|Company||1/31/20||1 mos change||YTD change||1/31/19||1/31/18|
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)||1/31/20||1/31/19||1/31/18|
|HH Index Total||11200||7780||4017|
Enterprise Value (EV), aka Selling Price, as Percent of Revenue
|HH Index Average*||286%||242%||124%|
Multiples of EV/EBITDA
Think of this as selling price as a multiple of EBITDA.
|HH Index Average*||28.13||26.24||16.88|
The Stoneridge Partners Post-Acute Care 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)
- Addus (ADUS)
- The Pennant Group, Inc. (PNTG)
- Encompass Health (EHC)
- Brookdale Senior Living Inc. (BKD)
This graph displays Post-Acute Care Index performance starting late 2019.
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 February 2020 | Stoneridge Partners)
Recent Transactions From Around The Country
- Alayacare acquired New York-based Arrow Solutions to tackle US Medicaid market
- Summit BHC, a Tennessee provider of addiction treatment and behavioral health services, has acquired Peak View Behavioral Health, which operates a 112-bed psychiatric hospital in northeast Colorado Springs
- Hospice Care of South Carolina, a portfolio company of The Vistria Group, acquired Agapé Hospice
Exclusively Listed For Sale By Stoneridge Partners
|State||Agency Profile||Status||Reference Number|
|Arizona||Opportunity to establish hospice in Phoenix area. ACHC accredited.||Available|
|California||$11 million multi-location addiction treatment center. Located in Southern California. 21% bottom line. Strong growth trends. JCAHO accredited.||Available|
|California||Medicare certified Home Health agency that was established in 2003. $2 million annual revenue in 2018. PDGM revenue neutral. Located in Southern California. Clean business with no ADR's.||Available|
|Colorado||Opportunity to establish Medicare home health agency. Denver market. ACHC accreditation until 2022.||Available|
|Florida||Medicare certified home health agency. Approx. $3.8 million revenue with 17% bottom line. District 9 & 10. Revenues split evenly between districts. Accredited. 4.5 star quality of patient care rating||Available|
|Georgia||ID/DD Services. $1 million revenue. Residential and Day Services. Atlanta Suburb.||Available|
|Illinois||$5.5 million accredited Medicare agency located in northeastern Illinois. Strong bottom line. 4 1/2 star rating by CMS.||Available|
|Louisiana||Boutique full service clinical laboratory specializing in preventative diagnostic testing.|
Medicare & Medicaid certified, and insurance contracts in over 20 Southeast States. Several unique programs and innovative technologies.
|Massachusetts||Medicare and Medicaid certified Home Health agency. |
$13+ million in annual revenue and growing. Diverse payor mix. Strong Management in place. Accredited.
|Massachusetts||Medicare/Medicaid Home Health Agency. Motivated seller in western MA. $7.5 million annual revenue. Great add-on for existing provider.||Available|
|Michigan||Medicare home health and hospice agency. $10 million annual revenue. Attractive referral relationships.||Available|
|Michigan||$2 million ID/DD. Profitable. Existing management team in place. Greater Detroit area.||Available|
|Michigan||$1.5 million private duty home health agency in eastern Michigan. Profitable and well positioned for additional growth. Self-sufficient staff in place. 82 long-term clients.||Available|
|Mid-Atlantic||$10+ million home care agency. Non-skilled, primarily Medicaid reimbursed. 20% EBITDA margins. Strong management team in place.||Available|
|Multi-State||Well-established pediatric provider. Revenue over $40 million. Medicaid and insurance.||Available|
|Nevada||Medicare certified home health agency. Approx. $1 million in annual revenue. Accredited. Las Vegas area.||Available|
|New Mexico||Home health and hospice. $15 million annual revenue. Revenue split: 2/3 Home health and 1/3 Hospice. Medicare/Medicaid certified. Accredited.||Available|
|New York||LHCSA in five boroughs. Approx. $20 million revenue. Long history in the community.||Available|
|New York||$13 million revenue LHCSA. 30-year history. Licensed in all 5 boroughs.||Available|
|New Mexico||$2.5 million New Mexico home health agency. 87% Medicare. Long history in the community. Staff in place.||Available|
|North Carolina||$1 million ID/DD Agency. Long-term client base. Growth potential with real estate. Strong margins.||Available|
|Oklahoma||Medicare certified home health organization. $9.6 million in annual revenue. 98% traditional Medicare and other PPS Payors. Medicare/Medicaid certification. Multiple locations.||Available|
|South||28 bed, IOP capacity of 40, full continuum SUD treatment center, dual diagnosis, pending JCAHO. $4+ million revenue, highly competitive in network contracts, average census of 30. Existing marketing relationships with county, parole, local hospitals, churches and universities. Solid business in desirable location, little competition, good opportunity.||Available|
|South||Full continuum, JCAHO accredited, co-occurring, SUD treatment center on 100+ acre horse ranch. 16 beds, 22 staff. $1.5 million EBITDA on $3.5 million revenue. In-network. Good reputation, great contracts/rates, solid opportunity. Census is great.||Available|
|South||National growth opportunity. No direct competition for niche market. Unique program and strong branding. PHP/IOP with census and revenue growth. Seeking strategic partner||Available|
|Southwest||$5+ million outpatient treatment center. Fully accredited. 37 beds. Recently revamped to increase growth and margin. Great census, UR, acquisition and solid numbers. Out of network and transitioning some in network.||Available|
|Southwest||64 bed full continuum treatment center in 2 Southwest US metropolitan cities.|
$4 million pro forma EBITDA run rate. 3rd location set to open May 2019. Run rate based on 30% occupancy with significant growth expected. Strong infrastructure to support growth trajectory.
|South-Atlantic||$12+ million in annual revenue. Home Health Agency (HHA) and Adult Day Care Center (ADC). HHA (represents 85% of revenue). ADC (represents 15% of revenue). HHA is primarily Medicaid business but is Medicare-certified. Accredited.||Available|
|South Texas||Hospice. $3.5 million in annual revenue. Accredited. Clean: No cap or regulatory issues.||Available|
|Tennessee||Very rare opportunity in a CON state. Located in Davidson County in Nashville, TN. Projected 2019 revenue in excess of $800,000.||Available|
|Texas||$5.3 million Medicaid agency in San Antonio, TX. 16.5% EBITDA. CHAP accredited. Staff in place for a smooth transition.||Available|
|Texas||$5.3 million all Medicaid Home Care company located in Houston, TX. 20%+ year over year revenue growth since 2016. Nice bottom line.||Available|
|Texas||$5 million revenue. Home health and hospice covering 10 counties in West Texas/Eastern New Mexico. No clinical issues, under CAP. Very profitable. Easily separated.||Available|
|Texas||$4 million home health agency. Dallas/Ft. Worth based. Full staff in place. Medicare and managed care with great contacts.||Available|
|Texas||$3.5 million Medicare certified home health agency. Located in San Antonio, TX. Fully staffed & CHAP accredited. Branch office included in sale||Available|
|Texas||$1.7 million Medicare home health agency. Located in Southwest Houston. Well-established with predictable referral sources. Very profitable.||Available|
|Texas||$1 million Medicare certified agency. Licensed in 7 counties in the Houston area. 80% is traditional Medicare.||Available|
|USA||New software application. Potential investment opportunity. Great test results.|
Helps connect those in recovery socially. Helps connect therapists to patients. Facilitates total successful recovery and gathers important helpful data.
|Virginia||$6 million Medicare certified agency in Northern Virginia.||Available|
|Virginia||$2.3 million revenue Physical Therapy and Wellness operation. 95% cash pay. Potential to franchise Nationwide. 2018 EBITDA $257,000.||Available|
|West||Premier provider of primary mental health services for adolescents aged 13-18. 2 locations. In process of growing in-network contracts.||Available|
|East||Healthcare testing laboratory. $7 million revenue, $4 million EBITDA. 16 employees, multiple state licenses.||Under Contract|
|Florida||$9.5 million Home Health Agency. Very strong operationally, clinically, and financially. 99% of revenue comes from traditional Medicare.||Under Contract|
|Florida||Medicare/Medicaid certified home health agency. $2.5 million annual revenue. 5-star. Accredited. District 10.||Under Contract|
|Kentucky||Medication-assisted clinic. IOP counseling for substance abuse and co-occurring disorders. Profitable with strong team in place. 150 clients. 95% Medicaid.||Under Contract|
|Kentucky||Medication-assisted Treatment center. Suboxone only. Strategic location between Louisville and Lexington, Kentucky. Great reputation with strong clinical team in place. 110 clients with room to expand and grow, minimal marketing. In-network contracts. Clients come in twice a month and pay $150 per visit for counseling. Owners are near retirement and will help with the transition.||Under Contract|
|North Carolina||$5 million Medicaid agency. CAP/PCS services. Long history, quality services.||Under Contract|
|Pacific Northwest||Full continuum in Washington State. $3,625,000. revenue with $1,100,000 EBITDA. States has moved from BHO to MCO for Medicaid. Co-occurring, Medicaid paid, 40 bed facility, 40 employees, census is very strong.|
Outpatient is full. Opportunity for marketing. SUD mental health gambling. Equine therapy and other perks.
|Southwest||$25 million in annual revenue. Provider of Waiver and ICF ID/DD Services. Statewide Platform. Strong management team. Excellent reputation for quality services.||Under Contract|
|Texas||Three Hospice companies with affiliated home health. $6 million total revenue. South, South Central, and South East Texas locations.||Under Contract|
|Texas||$3+ million hospice agency based in Dallas/Fort Worth. Well established. Clinically clean and growing. Full staff in place.||Under Contract|
|Texas||$1.4 million revenue pediatric therapy business. Company provides Physical Therapy (PT), Occupational Therapy (OT), and Speech Therapy (ST) to disadvantaged and disabled children in near a major metropolitan city in Texas and the surrounding counties. Positive reputation for providing quality help in an environment comfortable to the child. Founded in January 2008 as an investment for the owner. Average census is 190 patients with a goal of 225 for calendar year 2019.||Under Contract|
Do you know of any acquisitions that have taken place? We are interested in your comments. Contact us; Stoneridge Partners
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Home Health Index February 2020 | Stoneridge Partners