As industry specialists, our M&A advisors have extensive knowledge of the home care sector and the competitive landscape.

Conalliance is your expert for mergers and acquisitions in the home care sector, offering comprehensive support throughout the successful execution of your strategic initiatives. Whether navigating company sales, succession planning, acquisitions, partnerships, or securing growth capital, we provide tailored expertise at every stage. Furthermore, we deliver high-caliber advisory services, including due diligence, as well as precise valuations for both real estate and businesses.

Homecare aims to deliver outpatient therapy to patients using medical devices that require intensive consultation, accompanied by a comprehensive suite of related services. This sector is a critical component of outpatient care, bridging the gap between inpatient and home-based treatment, as well as within retirement and nursing homes. Aligned with the "outpatient before inpatient" model, homecare provides substantial value to stakeholders across the healthcare ecosystem: from developers, manufacturers, and after-sales service providers (medical product/service offering), to doctors, hospitals, rehabilitation, and care facilities (medical service offering), patients (medical service demand), and payers (medical service financing).

 

Homecare Services

Homecare enables patients to receive high-level outpatient therapy with complex, consultation-driven medical aids and associated services. These include enteral and parenteral nutrition therapy, oncology therapy, infusion treatments, stoma and incontinence care, advanced wound care, decubitus prevention, tracheostomy and laryngectomy therapy, long-term oxygen therapy, ventilation, compression therapy, and mobility support.

The "outpatient intensive care" sub-segment has witnessed significant M&A activity in recent years, driven in part by the growing interest of financial investors, resulting in market consolidation into a few major intensive care portfolios. For over a decade, ConAlliance has advised financial investors on entering or expanding within the outpatient intensive care sector, acting as both M&A advisor and commercial consultant. Our extensive track record includes references to the largest intensive care portfolios in Germany. Moreover, ConAlliance has successfully advised owners and shareholders of intensive care services on company sales, having facilitated numerous transactions on the sell-side.

 

Homecare Aids

Homecare aids are designed to ensure the effectiveness of treatment, prevent or mitigate impending disabilities, or compensate for existing disabilities. These aids not only improve patient quality of life but also help prevent or reduce the need for further care.

There are numerous aids classified as medical devices that support patients in managing everyday challenges and medical care in a home setting. The most important categories include mobility aids such as wheelchairs and accessories, walking aids, lift systems, and hospital beds. These products enable greater mobility and independence for patients. In the area of nutrition, enteral and parenteral nutrition play a crucial role in ensuring appropriate nutrient intake.

Additionally, there are fitness and monitoring devices such as heart rate monitors and circulation measurement systems, which are used for the continuous monitoring of vital functions. These medical devices are complemented by specialized homecare services, such as rehabilitation measures, infusion therapies, or respiratory therapies. Overall, these medical products and services significantly contribute to improving patients' quality of life and reducing the need for inpatient care.

 

With our deep expertise and established network in the homecare sector, you can rely on ConAlliance's years of transactional experience. We invite you to contact us to explore how we can support your strategic objectives.

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Dipl.-Kfm. Martin Franz

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Prof. Dr. Dr. Ulrich Hemel

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Cliff Murphy, MBA

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Homecare Mergers & Acquisitions: Strategic Imperatives

The homecare industry, encompassing both healthcare services and medical products, is experiencing a surge in M&A activity, driven by the need to adapt to market dynamics and achieve a competitive edge. Several key factors contribute to this trend, including the pursuit of economies of scale, geographic expansion, product diversification, and access to advanced technologies and patient data. Furthermore, the growing recognition of homecare as a cost-effective alternative to inpatient services, facilitated by advances in medical technology and digital health, strengthens the appeal of M&A in this sector.

Strategic Value of M&A in Homecare

From a strategic standpoint, mergers and acquisitions enable companies to consolidate resources, enhance operational efficiency, and rapidly acquire expertise in critical areas such as digital health. In a fast-evolving healthcare landscape, this agility is crucial. M&A activities allow for faster market entry or expansion, positioning companies to better capitalize on shifting demographics, especially the aging population and the rising prevalence of chronic illnesses.

Financial Considerations and Due Diligence

Evaluating homecare targets for acquisition requires a comprehensive analysis beyond just current cash flows. Synergies, cross-selling potential, and regulatory risks are critical factors. Given the sector’s highly regulated nature, thorough due diligence is indispensable to minimize compliance risks and ensure the sustainability of the business post-acquisition.

Market Consolidation in Outpatient Intensive Care

Within the "outpatient intensive care" sub-segment—also referred to as respiratory care, 1-to-1 care, or 24-hour care—there has been significant consolidation due to rising M&A activity, particularly from financial investors and private equity firms. Conditions such as chronic obstructive pulmonary disease (COPD), obesity hypoventilation syndrome (OHS), and neuromuscular diseases are driving the demand for intensive homecare services, making this sector a prime target for investment and consolidation.

Major players in the German intensive care market include Deutsche Fachpflege Holding (DFH), Bonitas, GIP/Pro Vita, Renafan, and Advita. Private equity firms like Adiuva Capital, Chequers Capital, and Advent International have already invested heavily in this space, contributing to the consolidation of major portfolios.

Drivers of M&A Activity in Homecare

1. Growing Demand for Homecare Solutions: The increasing demand for high-quality, scalable homecare services, driven by an aging population and rising chronic disease prevalence, is a major catalyst for M&A. By merging or acquiring companies, homecare providers can pool resources, enhance innovation, improve patient care, and reduce costs.
 
2. Access to Skilled Workers: The healthcare sector faces a severe shortage of skilled labor. Through strategic acquisitions, companies can gain immediate access to qualified professionals, ensuring service quality remains high.

3. Regulatory Challenges and Opportunities: The homecare sector is highly regulated, which can be a challenge but also a moat for companies that navigate these complexities well. Acquiring companies with a solid regulatory track record can provide competitive advantages.

Homecare M&A Landscape in DACH Key Regions

- Germany: Leading providers include Korian Germany, Schönes Leben Gruppe, Pflege zu Hause Küffel, and Home Instead Germany.
- Austria: Major players include SeneCura, CareRing, and Hausengel.
- Switzerland: Key providers such as Spitex Privat, Home Instead Switzerland, and Qualis Vita are shaping the homecare landscape.

Market Volume and Growth Forecast

The global homecare market is currently valued at approximately $225 billion, with an estimated compound annual growth rate (CAGR) of 7.7% through 2016, bringing the market to around $295 billion. The medical products segment, accounting for about 22% or $65 billion, is expected to grow at an even faster rate, with a CAGR of 15.5%. This growth is largely driven by an aging population, increased prevalence of chronic diseases, and a preference for cost-effective outpatient therapies.

Regions such as North America (42% market share) and Europe (23%) are expected to maintain stable growth, though much of the above-average growth potential lies in emerging markets like India, China, and Japan, where rising healthcare expenditures and aging populations present significant opportunities.

Conclusion: Strategic Importance of M&A in Homecare

M&A activities in the homecare sector are a crucial strategic tool for companies aiming to lead in this expanding market. The consolidation of resources, expertise in digital health, and access to new patient populations and skilled workers are just a few of the key benefits. However, successful M&A transactions in this space require precise execution, rigorous due diligence, and deep market knowledge. Given the complexities and opportunities in the homecare sector, partnering with seasoned M&A advisors is essential to ensuring long-term success.

With years of expertise in homecare transactions and an extensive network of industry contacts, Conalliance is well-positioned to guide both investors and operators through the complexities of mergers and acquisitions in this high-growth sector. Contact us to leverage our experience and ensure the success of your next strategic move.

In the Anglo-Saxon world (especially the USA and Canada), assistive products are covered by the German definition of Durable Medical Equipment (DME). (Note: DME is also a synonym for HME (Home Medical Equipment) or DMEPOS (Durable Medical Equipment, Prosthetics, Orthotics and Supplies). Homecare aids can be categorized into products / equipment, services and telehealth. Wheelchairs and wheelchair accessories are a key component of the assistive product segment mobility assistance / equipment.

Homecare Aids and Products

Assistive products market segment: Products / equipment, Self-diagnosis / testing / monitoring / screening: (among others), HIV tests, Blood pressure monitors, Blood glucose meters, ECG / EEG devices, Sleep monitoring devices, Drug and alcohol meters, Cholesterol meters, Tumor markers, Fertility and pregnancy tests, Therapy equipment / devices:, Portable oxygen equipment, air nebulizers, ventilators as respiratory therapy aids, Insulin pumps, Infusion pumps, Dialysis equipment, Orthoses, Prostheses, Cannulas, Hearing aids, Ophthalmologic aids, Mobility assistance / other mobility equipment:, Mobility equipment:, Wheelchairs and accessories, Walking aids, Lift systems, Hospital beds, Nutrition:, Enteral, Parenteral, Fitness:, Heart rate monitors, Circulation measurement / monitoring devices Assistive Products Market Segment: Services, Healthcare Services:, Rehabilitation Services, Infusion Therapy, Respiratory Therapy Assistive Products Market Segment: Telehealth, Telehealth Monitors, Monitoring Equipment / Monitoring Devices, Monitoring / Control Services