Aging America Care Economy
Ethan Plous@sauce
+5.1%
since Oct 6
The idea
I believe healthcare, especially elder and end-of-life care, is becoming the main engine of US job growth and economic activity, propped up by Medicare and Medicaid spending. So this owns the providers and landlords riding that volume, senior housing REITs, home health and hospice operators, nursing and dialysis facilities, plus distributors and staffing firms that get paid regardless of who wins among providers. It skips insurers, since rising utilization pressures their margins even as it fills beds and schedules.
What it owns
- The population over eighty is growing faster than new senior housing is being built, giving landlords pricing power as occupancy rises. · WelltowerThe largest senior housing landlord, it collects rent as the eighty-plus population fills its buildings and occupancy grows., VentasIt owns senior housing still recovering occupancy, so it stands to gain more upside than fully occupied buildings if the elderly population wave materializes., Omega Healthcare InvestorsIt collects rent from skilled nursing operators, staying solvent as long as government reimbursement keeps those tenants able to pay., CareTrust REITA smaller landlord acquiring care facilities, it compounds growth by purchasing assets in a market where elder care demand is filling available beds., National Health InvestorsA steadier senior housing and care landlord focused on stable income, it holds up as occupancy recovers and tenants cover rent.25%
- Older patients spend the most time in skilled nursing, rehabilitation and dialysis centers, where volume growth fills beds and chairs first. · The Ensign GroupIt acquires and improves skilled nursing facilities, gaining from rising occupancy and access to distressed operators as the take plays out., Encompass HealthIt operates rehabilitation hospitals where older patients recover after major events, a setting whose demand grows directly with the eighty-plus population., DaVitaHalf of the US dialysis market, it treats a mostly Medicare-funded patient base that expands as the population ages., Universal Health ServicesIt owns hospitals and behavioral facilities that absorb rising care utilization driven by an aging population seeking admission and treatment., The Pennant GroupA smaller operator running home health, hospice and senior living, it has room to grow if elder care spending expands as projected.24%
- End-of-life care is shifting from hospitals to homes, and these operators earn fees per visit as government programs fund the transition. · Chemed CorporationIts VITAS unit is the country's largest hospice operator, the most direct way to own the shift of end-of-life care spending at home., Addus HomeCareIt employs the home health aides delivering personal care, benefiting as demand for these workers outpaces supply in an aging society., BrightSpring Health ServicesIt operates home and community care for elderly and complex patients, growing as more older people need more hours of government-funded care., Option Care HealthIt delivers intravenous drugs at home, the cheaper setting where government payers are directing more complex care away from hospitals.24%
- Drug distributors and healthcare staffing firms earn fees on every prescription and every clinician hired, regardless of who delivers the actual care. · McKessonIt collects distribution fees on nearly every pharmaceutical moved in the country, earning more as overall care volume rises with an aging population., CencoraAs one of three major pharmaceutical distributors, it earns on volume; an older, sicker population means more prescriptions and higher revenue., Cardinal HealthIt distributes pharmaceuticals and medical supplies into home and facility settings where care is shifting, earning more as utilization rises., AMN Healthcare ServicesIt places nurses and clinicians, showing directly whether healthcare providers are hiring to meet growing demand from an aging population.17%
- Cash10%