Business Case Studies & Business Publications

Teleios: Profit and Purpose in the Hospi...

Kaufmann, Lauren, ...

Case

Teleios: Profit and Purpose in the Hospice Industry

Kaufmann, Lauren; Maiden, Stephen E.

E-0519 | Published July 16, 2025 | 21 Pages Case

Collection: Darden School of Business

Add To Cart Buy Now

Product Details

This case explores the strategic and ethical dilemmas faced by Chris Comeaux, CEO and founder of the nonprofit Teleios Collaborative Network (TCN), as he seeks to scale a mission-driven organization in a rapidly evolving hospice industry. TCN, established in 2018, supports nonprofit hospices by providing shared services, consulting, and a clinically integrated network to enhance operational efficiency and patient care quality. The case delves into the tension between maintaining TCN’s commitment to holistic, patient-centered care—rooted in the hospice movement’s origins—and competing against the growing dominance of for-profit, private equity–backed hospices, which prioritize cost efficiencies and profitability. By 2025, for-profit hospices accounted for over 70% of the market, raising concerns about care quality, patient selection, and ethical practices such as cherry-picking less costly patients or overbilling Medicare. Comeaux grapples with how to expand TCN’s reach to 20 states while preserving the organization’s mission of “Care as it should be,” navigating challenges like regulatory pressures, staffing shortages, technological disruptions (e.g., AI and telemedicine), and potential shifts toward Medicare Advantage plans. How should Comeaux grow TCN to 20 states—potentially standardizing parts of care—while maintaining the community ties within its current footprint? How can he scale a model designed to resist the very incentives driving hospice industry consolidation? The case highlights TCN’s innovative approaches, such as rebranding to soften the “hospice” stigma and exploring direct management of hospices, while addressing the broader question of how nonprofit hospices can remain sustainable and impactful in a profit-driven landscape. This case is well suited for courses in strategy, social impact, ethics, and health care management, where students can analyze the balance between mission and margin in a competitive industry.

• Understand how private equity shapes incentives and outcomes in mission-driven industries. • Analyze the strategic tensions in scaling a nonprofit network while preserving community-centered care. • Develop frameworks for measuring impact in emotionally and operationally complex industries like hospice care.