There is a struggle these days to find reliable and competent leadership. In many ways, the human services industry exemplifies the challenge. Despite an abundance of books, speeches, and guides that focus on the creation of good leaders, their absence persists.

This persistence, however, is not a result of our inability to pull good leadership from thin air. Rather, it's about our inability to simply look at the colleagues around us. Good management is cultivated, not found. This isn't a radical claim and is a concept I'm sure many are familiar with. But few, it seems, have managed to successfully cultivate new leaders. A complex reason why this challenge exists within the human services industry: gender disparity, especially for women of color. Human services is an industry that should, above all things, champion equity and equality for its clients/consumers — no question. Yet, if those same principles are not reflected in management, a company may find itself ill-equipped to champion anything. 

Owners of healthcare companies, practices, and agencies often ask us how they can increase their businesses' market value. Buyers determine the value of a business based on return on investment and riskiness of the investment. Business owners create value by increasing the return on investment and decreasing the riskiness of ownership.

A silver lining of the public health emergency is that it has forced many healthcare businesses to reevaluate their operations and refocus on what truly drives their success. For those businesses planning for a transition or future diversification, this has become even more important. One thing we have learned from the past year is that not everything we think is important really is necessary. In addition, we now have a greater understanding of and appreciation for the marriage of virtual care and transparency and how they, when combined, represent a powerful relationship.

As you may or may not know, I have been an advisor to owners of provider agencies supporting individuals affected by an intellectual and/or developmental disability (I/DD) for more than 30 years. I am fortunate in that I love this work. It is enormously gratifying to earn a living by helping others reach their goals. I am able to help business owners reach their financial goals and buyers achieve their growth and value-creation goals while improving the lives of employees and clients alike through the right transaction.

Each year typically brings at least some unforeseen developments that influence healthcare transactions. Oftentimes, these occurrences affect a single sector or just a few sectors. Rarely, if ever, is there an unexpected event that touches numerous marketplaces, let alone all of them, and does so in a dramatic way.

I was recently speaking with one of the sellers I represented about the sale of his provider agency. I asked him what he thought was my most significant value during his long selling process. Without skipping a beat, he said, "'The emotional support you provided to me." He explained that it was helpful to talk with me when things got stressful or even a bit scary since I had been through the process of selling my own company.

The only constant for home healthcare agencies is change. For many owners of agencies, change is both demanding and fatiguing. At some point, owners start thinking about exiting their company. Some owners elect to pass ownership down to their adult children. Some stop taking on new clients/patients and simply close their doors. Others seek to sell their company in the marketplace. This column is written for those owners considering selling in the marketplace.

As human services business owners and operators, we should not apologize when our businesses earn a profit. Rather, it's time to stop shielding our staff from the important discussion of budgets and bottom lines. They should have some exposure to the budgeting process and understand the need for a healthy bottom line.

As 2020 races to a close (or grinds slowly to the bitter end, depending on your viewpoint), the world is ready to turn the calendar page to new a year and, hopefully, a brighter season for all of us. Radical and sudden change is rarely greeted with open arms, and this has been a year of struggle and "new normals" for everyone. The VERTESS team would like to share some closing thoughts on the indelible mark 2020 has left on the healthcare market and what we might look toward in 2021.

The above is a map put together by our team at VERTESS. This map identifies some of the larger intellectual and developmental disability (IDD) competitors in the country, the states in which they do business, and their owner or ownership structure. Every healthcare industry uses this tool. These maps provide valuable insight into the competitive landscape of the respective industries. They are also a way of demonstrating why a healthcare business owner would be wise to partner with a merger and acquisition (M&A) advisor when the owner decides it is time to begin pursuing a sale of the company. Along with business size and service lines, buyers are often categorized by the geographic markets in which they're seeking acquisitions. Advisors should be aware of who is looking for acquisitions where.

I often receive calls from owners of human services companies who say something along the lines of, "I don't know what I don't know" concerning selling their company. What's important to understand is that it's okay not to know everything about selling a company. It's a complex process, which is why most successful sales involve a team working together toward a common goal.

As we approach the end of year, it's a good time to look back and identify some of the more significant pharmaceutical developments from 2020 that are playing a role in influencing or reshaping the industry. Here are eight noteworthy trends that emerged or gained steam this year that are likely to follow us into 2021 and beyond.