Why Mayo Clinic is exiting hospice care in Wisconsin—and who’s stepping in

How does St. Croix Hospice’s new deal with Mayo Clinic Health System reflect the shift in post-acute care models?

St. Croix Hospice is set to acquire Mayo Clinic Health System’s hospice operations across Northwest and Southwest Wisconsin, marking another step in a regional realignment of post-acute care. The deal, announced on August 1, 2025, is subject to regulatory approval and is expected to close later this quarter. This move expands the reach of St. Croix Hospice, already a leading hospice provider in the Midwest, and reflects a broader healthcare trend in which hospital systems divest hospice units to specialized care agencies.

The transaction follows an earlier, patient-centric handover of the Mayo Clinic Health System’s Mankato hospice program to St. Croix Hospice and builds on a well-established referral relationship between the two organizations. Executives from both sides have emphasized their aligned clinical values and shared focus on delivering compassionate end-of-life care.

Why are hospital systems like Mayo Clinic Health System offloading hospice operations to specialized providers?

Institutional sentiment suggests that health systems are increasingly seeking to streamline their operational footprints by exiting non-core businesses, such as hospice and other post-acute care services. Analysts point to cost pressures, labor shortages, and reimbursement complexity as catalysts for such divestitures. Rather than dilute resources across multiple service lines, hospitals are concentrating on acute care and leveraging partnerships with specialized providers like St. Croix Hospice to manage end-of-life care.

Richard Helmers, M.D., vice president of Mayo Clinic Health System in Wisconsin, explained that the move to transfer hospice services to St. Croix Hospice is rooted in an existing collaboration that has proven effective. He noted that the transition of the Mankato program served as a blueprint for ensuring continuity and quality during the handover process.

For St. Croix Hospice, acquiring hospital-based hospice programs represents a strategic expansion of its service model, allowing it to build deeper regional coverage without starting from scratch. This is the second such acquisition by the organization in less than a year, following its 2024 purchase of similar programs in Iowa and Nebraska.

What does this acquisition mean for patients and communities in Northwest and Southwest Wisconsin?

With this acquisition, St. Croix Hospice will directly manage hospice care for patients in communities previously served by Mayo Clinic Health System, including both inpatient and home-based hospice services. The Minnesota-based hospice agency already operates more than 85 branches across ten Midwestern states, including Wisconsin, and serves over 5,600 patients.

Mandy Cogswell, Chief Clinical Officer at St. Croix Hospice, described the transition as seamless for families, emphasizing the agency’s hyperlocal staffing model and clinical expertise. The organization’s integrated hospice approach addresses the physical, emotional, and spiritual needs of patients while offering proximity-based responsiveness across its growing footprint.

Industry experts note that such regional scale brings logistical advantages, especially in a labor-constrained environment. By consolidating operations under a specialized hospice agency, patients in rural and semi-urban areas can receive more consistent and coordinated care, backed by dedicated clinical protocols that differ from acute-care models.

How is St. Croix Hospice positioning itself in the evolving hospice care market?

St. Croix Hospice’s strategy appears to be one of targeted expansion through acquisition and integration. CEO Heath Bartness emphasized that hospital-based hospice divestitures are becoming a broader industry trend, with specialized providers like St. Croix stepping in to carry forward the legacy of hospital programs. The company views such acquisitions not only as growth opportunities but as a validation of its clinical capabilities and longstanding relationships with referring hospitals.

Bartness framed the move as a continuation of a collaborative tradition with Mayo Clinic Health System. The trust developed over years of referrals has translated into deeper operational partnerships, with St. Croix emerging as a preferred provider for high-quality, patient-centered hospice care.

Experts in healthcare operations suggest that this model is likely to accelerate as aging populations grow, regulatory pressures increase, and acute-care facilities seek to optimize resource deployment. Unlike generalist hospital systems, hospice-focused organizations like St. Croix are structurally designed to deliver care in non-hospital settings, often with lower costs and more personalized approaches.

What’s the broader outlook for hospice consolidation in the Midwest and nationally?

Analysts believe that the U.S. hospice sector is entering a new consolidation phase. Demographic tailwinds, such as the rising number of patients over the age of 65, are driving increased demand for hospice and palliative services. At the same time, the economic viability of smaller or hospital-run hospice programs is under scrutiny due to staffing challenges, cost inefficiencies, and administrative complexity tied to Medicare’s hospice benefit.

Regional players like St. Croix Hospice are capitalizing on this environment by building out dense operational networks that allow them to respond quickly to referrals, deploy staff locally, and maintain clinical quality across state lines. Their ability to scale through acquisition—without compromising care standards—is viewed positively by institutional stakeholders and state regulators.

This particular deal between St. Croix Hospice and Mayo Clinic Health System could serve as a model for other healthcare providers looking to reconfigure their service offerings. For now, patients in Northwest and Southwest Wisconsin can expect continued hospice care from a familiar partner, with broader operational backing and localized expertise.