The proposed deal between Addus HomeCare Corp. (Nasdaq: ADUS) and AccentCare would see Addus acquire nearly all of AccentCare’s personal care business. The move would add significant personal care scale to Addus, while leaving AccentCare more concentrated in home health, hospice and palliative care.

The deal marks a shift for AccentCare. In 2023, former AccentCare CEO Stephan Rodgers said that the company was very focused on the care continuum. Now, the company is narrowing its focus to the core of its operations.

This makes the deal another high-profile example of a home-based care company deciding that owning every piece of the continuum may not be the best fit for its strategy. For Addus, the deal represents an opportunity to grow in personal care. For AccentCare, it offers a chance to focus more on the clinical businesses it sees as central to its future.

With a company as joint-venture-minded as AccentCare, I can’t help but wonder if the deal will implicate the company’s JV strategy. AccentCare has long worked with health systems through JVs in home health, hospice and palliative care. As the company narrows its owned service mix, those partnerships could become an even more important way for AccentCare to stay connected to a broader care continuum.

In this week’s exclusive, members-only HHCN+ Update, I’ll explore the Addus/AccentCare deal, offering analysis and key takeaways, including:

• What the divestiture says about the one-stop-shop model 

• Why the deal could have implications for AccentCare’s health system JV strategy 

• What the transaction reveals about how major home-based care providers are defining their “core” businesses 

Not a one-stop-shop

I’ve used the phrase “one-stop-shop” a lot as a healthcare reporter. Whether companies offer a full continuum of care or specialize in a single product line is a major strategic decision, and we’ve seen several notable examples of home-based care providers changing course in recent years.

AccentCare is a clear recent example. The company’s website currently describes it as covering a broad continuum of services, consisting of personal home care, home health, palliative care and hospice. Once this deal closes, likely in Q1 2027, the company’s continuum of care will be shortened quite a bit.

From talking with sources, I have never gotten the impression that there is a right or a wrong way when it comes to determining the breadth of services. Some folks feel fervently that establishing a full continuum of care is optimal to improve care coordination. Others say that staying in their lane allows them to be experts at what they do, while relying on exceptional partners to ensure smooth handoffs and quality care.

It is clear that some high-profile aging-in-place giants have sold personal care businesses to focus on their home health and hospice arms. Those moves suggest that, for at least some large providers, the operational complexity of managing a broad continuum can outweigh the strategic benefits of having every service under one roof.

Amedisys’s 2023 divestiture of its personal care division to HouseWorks is one example. Amedisys’s two largest segments were home health and hospice, and the company narrowed its focus on these by selling.

“We strongly believe in the value of personal care and this divestiture allows our personal care division to grow under a proven leader in the industry while Amedisys focuses our attention on our core business units of home health, hospice and high-acuity care,” former Amedisys Chairman and CEO Paul Kusserow said at the time.

Addus was the buyer in one of these deals, when it acquired Gentiva’s personal care arm for $350 million in December 2024. Gentiva President and CEO David Causby said at the time that the deal allowed Gentiva to focus on its core businesses.

“This will ensure continued growth for that segment under proven leadership and will allow us to sharpen our focus on our industry-leading core hospice and palliative businesses, where we have the greatest opportunity to deliver the compassionate care that defines who we are, to those who need us the most.”

Both Kusserow and Causby used the word “core” in their statements about these mega-deals. That language is telling: These acknowledgments that the business did not fit the strategic priorities of their organizations.

A focus on “core” businesses for Addus and AccentCare is what came up when I chatted with Les Levinson, partner at Robinson+Cole, this week. He noted that AccentCare’s decision to divest nearly its entire personal care arm (save New York) reflects a shift to its core.

“If you really were interested in just divesting particular locations or regions, you could have done something differently,” Levinson said. “But basically, getting out of the entire segment indicates that that’s probably not going to be core to your operations going forward.”

To me, these deals show that major companies are placing meaningful bets on the narrow-field-of-expertise model. The question is not whether personal care is valuable — it clearly is — but whether it is more valuable as part of a larger continuum or as a standalone business operated by a company built specifically around it.

Moving forward, I’ll watch whether AccentCare’s shift to a narrower focus pays off, both operationally and strategically. I’ll also keep an eye on trends in the one-stop-shop vs. narrow-field-of-expertise game. I’ve previously written that General Atlantic’s $3 billion acquisition of TEAM Services was due in part to its position as a diversified infrastructure powerhouse. I think the choice to go broad or narrow can affect how attractive an organization is to investors. But investor appeal is not the only consideration. For a company that is not looking to sell — or one that has not reached the scale needed to support a broad continuum — narrowing its focus may be the better bet.

AccentCare’s JV strategy

AccentCare’s personal care divestiture is also worth looking at through the lens of its joint venture strategy. The company has built a number of partnerships with health systems over the years, including home health joint ventures with organizations such as Baylor Scott & White Health, Memorial Hermann, UCLA Health, UC San Diego Health, Fairview Health Services and Asante. It also has a hospice and palliative care partnership with ChristianaCare.

If AccentCare is shedding most of its personal care business while retaining its home health, hospice and palliative care platforms, its health system JVs could become an even more central part of the company’s strategy.

AccentCare has been talking about health system partnerships for some time, so I would not necessarily call this a full-on revitalization of its JV strategy. Former CEO Steve Rodgers told HHCN’s sister publication, Hospice News, that JVs were a focus for the company and a path to sustainable growth. But the personal care divestiture could make that strategy even more focused: AccentCare may be concentrating its attention on the services it believes can best serve as the clinical and operational backbone of those partnerships. 

The Memorial Hermann deal is a useful example. AccentCare and the Houston-based health system formed a JV in 2023 that combined their home health and hospice operations in the market, with AccentCare managing the organization. At the time, the partnership was framed around expanding access and reimagining home-based care. The structure illustrates the value proposition for health systems, in that they can stay a key player in the post-acute experience while leaning on a specialized home-based care operator for day-to-day management, staffing and clinical operations.

More broadly, health system JV activity reflects a familiar dynamic in home-based care. Health systems are increasingly looking for expert partners that can help them manage a service line that is strategically important but operationally difficult. Home health and hospice require specialized regulatory, reimbursement, workforce and clinical capabilities. A health system may want stronger visibility into what happens after discharge, but it may not want — or be best positioned — to run those businesses entirely on its own. That seems especially true at a time when health systems are under pressure to improve care transitions and manage costs, while home-based care operators are looking for reliable referral relationships.

That is where providers like AccentCare can fit.

For me, AccentCare’s portfolio moves complicate the one-stop-shop versus narrow-field-of-expertise conversation. The company is narrowing its owned service mix, but its JV model still allows it to participate in broader care coordination with health system partners. In other words, it may be pivoting away from being a one-stop shop of its own accord while still positioning itself as an expert partner for health systems that want to create a more connected continuum for their patients. That feels like an important distinction. AccentCare may be getting narrower as a company, but its role within a health system’s broader care ecosystem could potentially grow. I’ll be watching to see if AccentCare’s JV strategy shifts or expands following this deal.