Addus HomeCare Corporation will look for acquisitions. During Fourth Quarter and Year-End 2023 Earnings Conference Call Chairman and Chief Executive Officer, Mr. Dirk Allison said, "During 2023, we continued to experience strong cash flow from operations as our states and other payers have continued to pay in a timely manner. This allowed us to reduce our debt balance to approximately $126 million, inclusive of the funding of our acquisition of Tennessee Quality Care on August 1, 2023.

At year-end, our cash balance was approximately $65 million, which together with $335 million of availability under our existing credit facility continues to give us the financial flexibility to be opportunistic as we anticipate seeing additional acquisition opportunities coming to market over the next several quarters. It remains our primary focus to use our financial capacity to acquire strategic operations that align with our overall growth strategy of offering all 3 levels of home-based care in our Personal Care markets. As for our clinical segment, effective October 1, 2023, Medicare Hospice reimbursement was increased by approximately 3.1%.

On January 1 of this year, home health Medicare reimbursement was increased by approximately 0.8%. Although this year's home health rate increase was below what is required to recover ongoing operating increases, we believe that traditional Medicare home health reimbursement pressures are likely to moderate over the next few years, and we will continue to look for home health acquisition opportunities that are strategic to our overall growth". Brian Poff, Chief Financial Officer said, "Our fourth quarter results included a full 3 months' of operations of Tennessee Quality Care, a provider of home health, hospice and private duty nursing services, which we acquired on August 1, 2023.

The integration process has gone as expected, and we are excited about the opportunities to serve more patients in this strategically important market. Acquisitions remain an important part of our growth strategy, especially situations with a profile similar to Tennessee Quality Care, where we have the ability to leverage our strong Personal Care presence and add clinical services. We are optimistic that we will see additional attractive acquisition opportunities in 2024 as we gain more clarity on pending reimbursement issues and other regulatory changes that could affect Addus in our industry".