Why St. Croix Hospice’s second Mayo Clinic acquisition could reshape hospice care in Wisconsin

St. Croix Hospice has entered into a definitive agreement to acquire the hospice operations of Mayo Clinic Health System in Northwest and Southwest Wisconsin, marking another milestone in the hospice provider’s aggressive regional expansion. The deal, announced on August 1, 2025, is pending regulatory approval and is expected to close later in the quarter. This acquisition reflects an ongoing trend in healthcare: the consolidation of hospice care into specialized private operators as hospital systems streamline their post-acute care portfolios.

The two organizations have a longstanding partnership, with St. Croix Hospice having served as a primary referral recipient for hospice patients transitioning out of Mayo Clinic Health System care. The transition builds upon a recent example—St. Croix’s absorption of the Mayo Clinic Mankato hospice program—which institutional leaders described as seamless and “patient-centric.”

With more than 85 locations and 5,600 patients across the Midwest, St. Croix Hospice is already a dominant player in the regional end-of-life care space. This latest acquisition signals the firm’s intention to solidify its footprint in Wisconsin and adjacent states through integration of health system-operated hospice assets into its specialized model of care.

How does this deal reflect larger trends in health system divestitures of post-acute care operations?

This transaction is part of a growing national trend of health systems divesting non-core service lines like hospice, home health, and skilled nursing in favor of tighter acute care integration. According to industry executives, hospital-based hospice programs face scalability and reimbursement constraints that specialized providers like St. Croix Hospice are better equipped to handle.

St. Croix Hospice Chief Executive Officer Heath Bartness noted that the firm is increasingly seeing health systems step back from post-acute services, citing operational complexity and shifting strategic priorities. Bartness emphasized that the acquisition reflects Mayo Clinic’s trust in St. Croix’s clinical standards and ability to provide continuity of care.

This latest deal follows St. Croix’s fourth-quarter 2024 acquisition of hospice programs in Iowa and Nebraska, making the Wisconsin expansion the second major regional acquisition from a health system in under 12 months. With hospital-based hospice care under pressure, industry observers believe that private operators like St. Croix Hospice may be positioned to consolidate the space, particularly in underserved or rural areas.

What role does continuity of care and local integration play in St. Croix Hospice’s strategy?

St. Croix Hospice has built its business model around localized clinical care teams embedded in the communities they serve. Its acquisition of Mayo Clinic’s Wisconsin operations is expected to preserve continuity of care for existing patients, many of whom have already been served by the provider through earlier referral arrangements.

Mandy Cogswell, Chief Clinical Officer at St. Croix Hospice, stated that the acquisition is grounded in a shared commitment with Mayo Clinic to “clinical excellence and innovation,” enabling a smoother transition for both patients and staff. Cogswell emphasized that the firm’s Midwest coverage and integrated care framework are essential to delivering tailored support—physical, emotional, and spiritual—to hospice patients where they live.

St. Croix Hospice clinicians currently operate in ten Midwestern states, including Minnesota, Illinois, Indiana, and South Dakota. Its proximity-based model allows for 24/7 responsiveness, an essential factor for terminally ill patients and their families. By inheriting Mayo Clinic’s operational footprint in Wisconsin, the hospice provider will strengthen its network in key counties while upholding personalized care standards.

How have institutional sentiments and historical performance shaped St. Croix Hospice’s recent M&A activity?

Institutional sentiment around hospice care consolidation remains largely favorable, particularly as investor interest has grown in healthcare models that emphasize operational efficiency and outcome-driven care. While not publicly traded, St. Croix Hospice has drawn attention for its disciplined approach to acquisitions, focusing on seamless integrations and continuity rather than rapid expansion for scale’s sake.

Historically, the American hospice provider has focused on acquisitions that already have overlapping patient populations or referral ties. The 2024 Mankato hospice transition was viewed as a proof point, with Mayo Clinic Vice President for Wisconsin operations Dr. Richard Helmers describing it as “thoughtful and patient-centric.” That deal helped build trust between the two organizations, laying the foundation for this second transaction in Wisconsin.

As health systems like Mayo Clinic Health System evaluate the return on investment from maintaining internal hospice services, divestiture strategies are becoming more normalized. Analysts expect more such agreements to emerge, particularly in regions where independent hospice operators offer better economies of scale and community integration.

What does the future look like for hospice care providers amid ongoing consolidation and demographic trends?

Looking ahead, the demand for hospice services is expected to rise sharply, driven by an aging population and growing emphasis on home-based end-of-life care. Operators like St. Croix Hospice are positioning themselves to meet that demand by expanding clinical capacity and geographic reach while preserving quality benchmarks.

Industry watchers believe that partnerships between health systems and specialized hospice providers will become more formalized, possibly involving long-term affiliation agreements or value-based care arrangements. With hospice providers now viewed as essential players in the continuum of care, institutional support is likely to increase for operators that demonstrate both clinical capability and efficient onboarding.

St. Croix Hospice’s strategy appears aligned with this trajectory. By focusing on service proximity, regulatory compliance, and patient satisfaction, it is cementing its role as a preferred partner for health systems looking to exit hospice service lines without compromising on care quality.

In the Midwest in particular, where aging rural populations and limited healthcare infrastructure create persistent access challenges, St. Croix Hospice’s regional presence could play a critical role in bridging end-of-life care gaps. Many rural counties across Wisconsin, Minnesota, and neighboring states continue to face shortages of specialized palliative and hospice providers, forcing families to rely on distant facilities or fragmented services. By integrating Mayo Clinic Health System’s hospice operations into its existing footprint, St. Croix Hospice is not only expanding geographical coverage but also enhancing care proximity—ensuring that more patients can access coordinated, timely, and compassionate care close to home.

This strategic move strengthens the provider’s logistical and clinical response capacity in underserved regions, especially where health systems are increasingly stepping back from non-core services like hospice. As a result, the Wisconsin expansion not only reinforces St. Croix Hospice’s role as a leading provider in the Upper Midwest but also signals a broader shift toward a more mature and purpose-driven M&A model within the hospice sector—one where clinical alignment, operational integration, and continuity of care are prioritized over pure network size. For institutional stakeholders and health systems seeking long-term care partners, this represents a compelling blueprint for patient-centric transitions in post-acute care delivery.