St. Croix Hospice has entered into a definitive agreement to acquire hospice operations from Mayo Clinic Health System (MCHS) in Northwest and Southwest Wisconsin, reinforcing its position as a leading provider of end-of-life care across the Midwest. While the financial terms of the deal were not disclosed, the acquisition marks St. Croix Hospice’s second major expansion from MCHS in less than a year. The transaction is subject to regulatory approval and is expected to close by the end of the third quarter of 2025.
This development follows the late-2024 acquisition of MCHS’s hospice operations in Mankato, Minnesota, by St. Croix Hospice, which was broadly seen as a strategic consolidation of regional hospice services. With this latest transaction, St. Croix Hospice will assume control of hospice operations in two critical regions of Wisconsin, helping to standardize patient transitions from MCHS hospitals to hospice care while aligning with broader healthcare system trends toward divesting non-core post-acute assets.
Why is Mayo Clinic Health System exiting hospice care in parts of Wisconsin?
According to Mayo Clinic Health System leadership, the decision reflects a strategic focus on core hospital-based services and an intent to partner with specialized organizations for post-acute care. Dr. Richard Helmers, vice president of Mayo Clinic Health System in Wisconsin, emphasized that the relationship with St. Croix Hospice has proven highly effective in ensuring quality continuity of care.
“We’ve built a strong collaborative relationship with St. Croix Hospice, grounded in a shared commitment to compassionate, high-quality end-of-life care,” said Dr. Helmers. “The transition of our Mankato hospice program was thoughtful and patient-centric, giving us confidence in this next step.”
MCHS’s move is part of a broader divestiture wave sweeping across hospital systems in the U.S., particularly in post-acute care services such as home health and hospice. With healthcare margins tightening and labor shortages complicating service delivery, many health systems have opted to focus on acute care infrastructure while outsourcing hospice to regional specialists like St. Croix Hospice.
How will St. Croix Hospice manage the transition and operations?
St. Croix Hospice, headquartered in Mendota Heights, Minnesota, operates more than 85 locations throughout the Midwest, with care teams based in local communities. The organization focuses exclusively on hospice services and has been a key partner for patients discharged from MCHS facilities who require end-of-life support at home or in residential hospice centers.
Mandy Cogswell, Chief Clinical Officer at St. Croix Hospice, noted that the integration would be seamless for patients and caregivers. “Our teams have been proudly providing hospice care for MCHS patients throughout the Midwest for many years,” said Cogswell. “This collaboration ensures continuity of care, supported by aligned clinical priorities that put the patient at the center.”
Operationally, the acquisition is expected to follow a structured handoff model developed during the Mankato integration, which included shared case management systems, co-led staff training, and coordinated outreach with patient families. These procedures are designed to minimize disruption while preserving the MCHS legacy of care.
What is driving M&A activity in hospice and post-acute care?
St. Croix Hospice CEO Heath Bartness framed the move as part of a growing trend in healthcare consolidation. “We are seeing hospital-based post-acute divestitures emerge as a dominant trend,” he said. “We appreciate our long-standing referral relationship with MCHS and are pleased to continue their tradition of clinical excellence.”
Healthcare analysts have pointed to several drivers behind this consolidation wave. Rising operational costs, Medicare Advantage penetration, and a shift toward value-based payment models are prompting health systems to offload lower-margin service lines like hospice. These dynamics have made hospice providers with operational specialization—such as St. Croix Hospice—attractive acquirers for system divestitures.
According to data from the National Association for Home Care & Hospice (NAHC), hospice M&A volume surged by over 20% in 2024, with regional players absorbing system-run programs in states like Iowa, Michigan, and Illinois. The transactions are often structured to retain local staff and maintain patient care standards while boosting efficiency through centralized back-end operations.
St. Croix Hospice itself has been one of the most active acquirers in the Upper Midwest hospice segment, with support from private equity ownership that has prioritized regional scale and clinical quality. While exact revenue figures are private, industry estimates place St. Croix Hospice’s annual revenues in the $200 million to $250 million range.
How are patients and families likely to be affected?
For patients currently enrolled in MCHS hospice programs in the targeted regions, services will continue uninterrupted during the transition period. Following regulatory clearance, St. Croix Hospice will assume full responsibility for care coordination, staff management, and compliance under its own license.
Family engagement has been a hallmark of St. Croix Hospice’s approach, often cited as a differentiator in CMS quality scores and family satisfaction surveys. The provider’s in-home services are bolstered by proprietary care management tools and 24/7 nurse access—capabilities that may improve consistency across the newly acquired territories.
Internal transition teams have already begun planning for asset integration, staff onboarding, and communication with referring physicians. The company is expected to offer employment to a majority of MCHS hospice staff affected by the divestiture.
How does this deal reflect broader healthcare strategy shifts?
The hospice acquisition reflects a macro-level shift toward ecosystem partnerships and care segmentation. As hospitals narrow their operational scope, specialists like St. Croix Hospice are becoming critical nodes in the continuum of care, particularly for aging populations and patients managing chronic conditions.
Wisconsin’s demographic profile supports this trend. According to the U.S. Census Bureau, nearly 20% of the state’s population is aged 65 or older. The rising need for end-of-life care, particularly in rural and semi-rural areas, has strained traditional hospital systems, making hospice agencies indispensable.
Mayo Clinic Health System’s approach mirrors similar moves made by Ascension, Advocate Health, and other multistate systems that have either sold or outsourced hospice and home health arms to focus on tertiary and quaternary care services.
How are industry stakeholders responding to the announcement?
While neither party has disclosed financial terms, early sentiment in the hospice care sector suggests the deal is being viewed favorably. Industry analysts note that MCHS’s choice of St. Croix Hospice reinforces confidence in their care quality, while market observers expect continued M&A activity in the region.
“There’s a recognition that purpose-built hospice providers can often scale faster and deliver consistent care outcomes compared to general health systems,” one senior healthcare advisor noted. “This type of acquisition is not just financially strategic but operationally smart.”
Although St. Croix Hospice is not publicly traded, its growing footprint could eventually position it for further capital raises or long-term strategic partnerships. If the Midwest hospice consolidation trend continues, the organization may become a pivotal platform in future roll-up strategies or even private equity exit events.
What are the next steps for St. Croix Hospice following this deal?
Following regulatory approvals, St. Croix Hospice will initiate the formal integration of MCHS’s Wisconsin hospice programs into its operations. In parallel, the company is expected to pursue further expansion opportunities across neighboring states, supported by its existing partnerships and referral pipelines.
Staff onboarding, electronic health record (EHR) migration, and community outreach campaigns will form the core of the next operational phase. Given the successful precedent of the Mankato transition, expectations are high for a smooth implementation across Wisconsin.
Bartness indicated that the company remains “actively engaged in identifying other partnership opportunities” and may look to deepen its reach in rural markets underserved by traditional providers. The strategy suggests a long-term commitment to building hospice capacity as health systems retrench and delegate care pathways.
If completed as expected, the Wisconsin acquisition will bring St. Croix Hospice closer to the 100-location milestone—further solidifying its place as a Midwest leader in specialized end-of-life care.
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