In recent years, Choice Health at Home has shaped up to be a company to watch in the home health space, and Trive Capital is one of its backers.

Based in Dallas, Trive Capital is a private equity firm that has increasingly invested in the health care space.

Brad Wiginton, managing director and head of business development at Trive Capital, recently connected with Home Health Care News at the FUTURE conference to dive deep on his company’s strategy.

During the conversation, Wiginton also explained why Trive Capital believes there’s still major opportunities in the home health space.

HHCN: You’re invested in home health care through Choice Health at Home. Your investments also include behavioral health and primary care. Why those service lines, specifically?

Wiginton: As generalists, we’re pretty opportunistic. A lot of the situations that we dig into are what we consider defensible niches. Our primary care business, it’s a VA-focused business and serves a niche. It is really one of the dominant players in that niche.

What we try to look for is differentiation and something that has a significant role and presence in our market that we think is both defensible and has longer-term tailwinds. On the behavioral health side, there’s a lot of different areas and aspects to play in that market.

You invested in Choice prior to rate cuts over the last few years. Why do you still think there’s opportunity in home health care in general?

I think that when we entered the choice investment, PDGM had just been announced. We think about regulatory, more broadly, as having some level of visibility about dramatic changes that are going to completely reshuffle the deck. That was something that, from a timing perspective, made sense. I think that while there may be continued near-term pressures, what we see is at the end of the day, folks are going to continue to drive and need to do more at home. I think that having a diverse portfolio — at Choice we’re not just in skilled home health, but also have hospice and personal care — has served us well as we navigate rate cuts in certain areas of our market. I think that really the outlook around long-term growth is what we’re more focused on.

Why was Choice an opportune provider to go after, at the time you did?

Home health was actually a segment that we’ve been looking to invest in for several years. It’s obviously a very fragmented market despite years of consolidation. While we’ve seen a lot of different home health and hospice providers over time, I think for us, it was finding a backable team that had the proven ability to grow and scale.

A lot of folks here have the opportunity and blessing to get to know [Choice CEO] David Jackson. The team that he had already put around him, as well as what he’d been able to accomplish prior to us investing – starting within rehab, developing home health and entering hospice. Right as we were working with him, he was exploring a significant JV. It was very different from a lot of operators that we had seen and looked at in the past.

What’s the value in having the full continuum in the home?

When you think about your loved ones, you want to have a trusted partner to take care of [them]. There’s an element, for sure, of trying to be folks’ trusted partner for their seniors. That may start with something more basic, like personal care services, and evolve into something greater.

Choice has been able to care for multiple members of the Trive family. Wherever they are in their journey to care for loved ones and friends — they’ve been able to meet that need. Having that relationship is really beneficial.

When I first connected with Choice, in 2021, they were far smaller than they are now. What can capital do for a provider like that? What are some of the do’s and don’ts?

In picking a capital partner, there’s a wide range of what that can look like.

Choice was a really Texas-focused business. One of the things we’ve been able to do is to enter additional markets, but with a focused approach. Instead of spreading out to 10 states all over the country, we’ve been very focused on the Southwest and scale and density within our markets.

Growth doesn’t happen just in a straight line. One of the things that we’ve experienced is a focused time of M&A, where we focused on building the bones and what we’re trying to create. Then really taking a step back, integrating these businesses, getting them on the same EMR and getting consistent processes across different markets and regions. We’re really excited about a lot of the de novo and things that we’re doing to densify in our key markets. There’s kind of that ebb and flow of how you approach growth. For us, we want to do it in a balanced way where we’re not just growing through M&A, but also through opening new markets here, and adjacent to our current markets.

Would you consider other home-based care investments in the future? Is there anything you’re looking for right now?

Our focus today within home health is Choice, and we’re really excited about what we’re building there. As an investor, it’s hard not to imagine what, down the road, you might do when given the opportunity.