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March 20, 2025

How a Lewiston health care nonprofit diversified to sustain services

Photo / Courtesy Andwell Health Partners On Wednesday, Andwell Health Partners cut the ribbon on Andwell Audiology in Lewiston. From left, Dr. Vance Brown, chief medical officer; Dr. Josh Huppert, clinical director of audiology, Brianne Genschel, associate director for Andwell Medical Partners and Mat Collins, vice president of medical and community services.
By Laurie Schreiber

Ken Albert leads Lewiston-based Andwell Health Partners, an independent, nonprofit home- and community-based health care organization.

The former Androscoggin Home Healthcare and Hospice, founded in 1966, focused on home health care and hospice in Androscoggin, Oxford and Franklin counties.

A person poses for a headshot.
Photo / Courtesy Andwell Health Partners
Ken Albert

Rebranded in 2024 to reflect its expansion in recent years, Andwell now has locations throughout Maine, with additional service lines including in-home hospice care, Maine’s first inpatient hospice facility, the Maine Center for Palliative Medicine, community and behavioral health, mobile wound care, in-home care giving, private-duty nursing, therapy care, ad maternal and child health. This week, it opened Andwell Audiology in Lewiston. 

Mainebiz asked Albert about Andwell’s evolution. Here’s an edited transcript.

Mainebiz: What kicked off Andwell’s expansion?

Ken Albert: We’ll be 60 years old next year. For a good 50 of those years, we served Androscoggin, Oxford and Franklin counties, primarily, if not exclusively, through skilled home health care and hospice service. Four years ago, we added a medical practice and launched the Maine Center for Palliative Medicine. We’re now up to 16 providers in that practice and collaborating with hospitals around Maine to create access points for that service. 

MB: How has Andwell decided on further expansions?

KA: That’s part of the health partner piece. We don’t just land in a community and hang a shingle. We talk to hospitals, to other health care organizations. We look to see where the gap is, whether it’s behavioral health, hospice, palliative care, pediatric care. Then we look to fill that gap. Now we serve from York to Aroostook, although it’s not all services in all communities. 

MB: Was there a tipping point that prompted Andwell’s expansion? 

KA: As we look to the future for how health care will be reimbursed, it became clear that we needed to diversify in order to sustain services. Home health services are a really important adjunct to the health care model for hospital discharges. Home health providers are largely for-profit now in the U.S. The nonprofit provider in the home health community is slowly disappearing. But in rural parts of the country, like Maine, the nonprofit is vitally important as a collaborator with hospitals. But the way it’s being reimbursed, we had to say, “Okay, we have to diversify if we’re going to be able to sustain these services, because the margin for home health is narrow or not there at all.”

So we asked ourselves, What is our skill set? What can we leverage from the skills of our clinicians and what services can we bring to communities that will create greater access to needed services?

MB: What are Andwell’s growth trends?

KA: Nine years ago, we were a $24 million company with a little over 400 employees, serving about 1,800 patients per day. Now we have 800 employees and we’re a $65 million to $70 million company on the revenue side. We’re serving about 4,500 patients per day across all our service lines. That includes about 900 pediatric patients. We’ve really expanded access to pediatric services — its’ a clinical service that’s declining at a time when need is rising, again because of reimbursement. 

MB: How are you funding new locations and services?

KA: As we expand new services, we build it slowly. As the volume of services comes in and the revenue starts flowing, we add more staff to cover more volume. 

MB: Several of Andwell’s expansions involved mergers and acquisitions. Does that reflect the health of the acquired or merged organizations in any way?

KA: Across the country, merger and acquisition activity is going through the roof in health care — we’re seeing private equity infusion in health care at a rate we’ve never seen in the U.S. before. It’s not necessarily about the economic or financial health of the organization. It’s the leaders of the organizations coming together to ask, “Can we scale and can we better serve our communities if we do it together, combining resources?” Every nonprofit has human resources, revenue cycle management, financial departments, marketing and development—all those back-end services. One of our strategies was to develop shared service centers of excellence so that we would be attractive to other organizations that we wanted to acquire or to merge with. So we’re creating scale by reducing the overall cost of those back-end services.

MB: Are you seeing impacts from funding situations at the federal level? 

KA: Absolutely. We found out this week that our funding from Congressionally directed spending for our nurse practitioner fellowship training program — one of only eight in the nation and the only one in the nation focused on rural access to palliative medicine — was cut. So we have to rethink that program and try to find different ways to collaborate and find alternative funding. 

MB:  What about proposed cuts to Medicaid? 

KA: Medicaid cuts would change the landscape of health care in Maine. We’ve seen a decline in health care providers willing to take Medicaid in general because the reimbursement is 40 to 50 cents of the dollar on cost; it’s always been a payer that hasn’t covered costs. As a nonprofit organization, it’s been part of our mission to take care of that vulnerable population. Now that Medicare margins and third-party-payer margins are declining for everyone — hospitals, long-term care providers, others — that’s being felt by the Medicaid population because we’re having to cap our percentage of Medicaid as an overall percentage of our payer-mix. When you’re looking at an $880 billion carve-out of Medicaid across the country, the existential threat is for our elderly, for our children, for the populations that Medicaid has been intended to take care of. We’re going to have to go to the drawing board and collaborate as health care providers to reframe and reshape how we deliver health care to meet the needs of this oftentimes marginalized population.

About Andwell

The word Andwell is an amalgamation of the organization’s history, mission and services: “And” honors the Androscoggin County roots, “well” celebrates the focus on health and wellness and “dwell” highlights the care delivery system of in-home health. The second part of the name, Health Partners, represents the organization’s mission to be a trusted partner to its patients and clients, with a focus on wellness, not illness. It also serves as health partner to other health care organizations that refer to and depend on Andwell. 

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