Some Home-Based Care Providers Are Expanding Service Lines, Others Are Doubling Down On Status Quo

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To expand into new service lines or stand pat, that is the question. Some home-based care providers believe expansion is necessary, while others are doubling down on their current offerings.

Choice Health at Home is a provider that falls into the former category.

The Tyler, Texas-based Choice Health at Home is a home health, hospice, palliative care, rehabilitation, and home care services provider. It operates locations across Texas, Arizona, Louisiana and Oklahoma.


Recently, Choice Health at Home expanded its services and entered into geriatric behavioral health, in the realm of dementia and Alzheimer’s care. The company plans on building out these services even further next year, Choice Health at Home CEO David Jackson told Home Health Care News.

“We feel like it’s a tremendous need within the geriatric population in the United States,” he said. “We feel like it’s an underserved population, largely because facilities that serve these populations were put under significant stress during the pandemic and have not fully recovered. Patients that want to be at home have very limited resources, so Choice is actively developing clinical resources and education for family members.”

While beefing up this new service line, Choice Health at Home has zeroed-in on making sure its employees have the right training and education.


“This is really, really new for Choice, and we’re very excited about what that means,” Jackson said. “We’ve been really pleased that our clinicians, and our employees, have really engaged in the educational components.”

Similarly, BrightStar Care is embracing expansion into new services lines, such as skilled services.

The Chicago-based BrightStar Care is a home care and medical staffing franchise with more than 380 locations nationwide. The company provides medical and non-medical services to clients in their homes, as well as supplemental care staff to corporate clients.

As part of its move toward offering more skilled services, BrightStar Care has set a goal to have 75% of the company’s network providing skilled nursing services, including nursing and therapy services.

“We’ve invested very heavily in continuing to build out our proprietary technology platform that, I believe, makes us somewhat unique in the space,” BrightStar Care CEO Shelly Sun told HHCN. “We’re able to offer both skilled services and personal care services for those that are doing higher-acuity in the home, whether that’s a skilled-nursing facility alternative, or hospital at home — we can kind of be their last mile.”

In order to pull this off, BrightStar Care has sought out feedback from its franchise owners and directors of nursing across the country.

“We’ve been doing a lot to garner input from our franchisees and directors of nursing as to the technology and third-party services that they need to be able to allow them to offer the highest level of consistent skilled services, from a technology and automation perspective or a reporting clinical dashboard perspective,” Sun said. “Those have been investments that we have prioritized and will continue to prioritize during 2024.”

Even though BrightStar Care and Choice Health at Home are already providers with diverse service offerings, this doesn’t make these organizations immune to the headwinds that come with expanding.

At Choice Health at Home, the focus has been on bringing in more workers as the company’s geriatric behavioral health service line continues to take shape.

“We feel like we can meet that challenge,” Jackson said. “In 2022, Choice had more employees than we ever had in the history of our business, and we’re really proud of that. We’re going to continue to invest in employees as we move forward.”

On its end, BrightStar Care has been able leverage its company-owned locations to experiment and lessen potential headwinds.

Currently, BrightStar Care has 32 company-owned locations across the country.

There are also other service areas Choice Health at Home and BrightStar Care are entering into for the first time, such as remote patient monitoring for the former, or initiatives around Medicare Advantage (MA) for the latter.

Looking past 2024, Jackson and Sun have identified other services areas that have piqued their interest.

For Jackson, this includes medication delivery and home infusion, though no plans have been made to move into these areas as of yet.

Meanwhile, BrightStar has dipped their toe in medication delivery and small-home senior living, but will look for opportunities to expand beyond the pilot phase in the coming years, and continue to grow their stronghold in home infusion.

That said, both leaders emphasized the importance of a deliberate, slow, steady approach to expanding. 

“You have to be careful about not chasing shiny objects,” Sun said. “I think critical focus with limited resources can win the day, but you don’t want to let something that could be really large and impactful get away from you. Our philosophy is to pilot small — three to five locations. Businesses should be cautious about trying to do too much, too broadly, and not give up the opportunity cost of doing more of what is already working.”

With this in mind, some providers are making the case for why it was important for them to double down on their company’s core services, rather than move into new services areas at this time.

“I value why many organizations would want to diversify,” Frontpoint Health CEO Brent Korte told HHCN. “Aside from the obvious financial value of ensuring that your business isn’t putting all of its eggs in one basket — we think that the home health basket is a strong one even in the face of regulatory headwinds.”

Dallas, Texas-based Frontpoint Health is backed by the PE firms Cimarron Healthcare Capital and Tacoma Holdings. The company offers home health and hospice, and has made MA opportunities the focus of its business.

Korte believes that there is a growing underserved, or unserved, population among MA patients.

“Over 50% of Medicare eligible recipients are now signed up with Medicare Advantage plans, and the majority of home health turns away from these patients for good economic reasons, because it’s very difficult to provide care to them,” he said. “We, however, view this as potentially the best and greatest opportunity for the next decade for home health. Why aren’t we diversifying? Because we have our hands full.”

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