Enquirer Consulting Group

Reachable Buyer Map

Prepared for Daniel Hernandez · OnePoint Patient Care · September 2026
Here is the map Ana promised, on the market you sell into: US hospice organizations. Every hospice in the country is federally certified, so unlike most markets this one can be counted rather than estimated. The page splits that universe into the groups that buy differently, shows roughly how many organizations sit in each, and names who owns the decision inside them. One layer has no honest public count and the page says so instead of showing you a number. It maps the market around you, not you. There is nothing to buy at the end of it.
Where the decision sits
Five groups. They overlap on purpose and must never be added together: a newly certified hospice can also be chain owned and also be small. They are patterns of buying behavior, not slices of a pie. Counts come from federal program files read in full this month, and the note under each number says exactly what it counts.
Independent single site hospices
The long tail, and numerically the market. Most certified hospices are small, locally owned and run without a pharmacy function of their own. Nobody inside the building has pharmacy as a full time job, which is exactly why the relationship gets bought once and then left alone for years. The buying process is short and personal, and the whole decision usually sits with one or two people who already know each other.
Who decides: the owner, administrator or executive director, often in a single conversation without a committee.
Who raises the pain: the director of nursing or clinical services, because a delivery that misses at two in the morning is their phone that rings.
About 4,200
providers served fewer than 250 distinct beneficiaries in the 2024 reporting year, out of 6,134 with a record that year. Not every one of these is independent, but this is where the independents sit.
Chain owned and financially owned groups
The row where the decision moves out of the building. Once an organization sits under a chain home office or a financial owner, pharmacy stops being a local relationship and becomes a contract negotiated above the site, usually with a standard agreement applied across every location. Winning here is slow and wins many sites at once. Losing here loses many at once too, and the site level people you know well may not be told until it is done.
Who decides: a regional or corporate operations lead, with finance beside them. In the largest groups a corporate pharmacy or supply chain owner exists as a distinct seat.
What they ask first: what happens across every site, not what happens at one.
310
organizations sit under a chain home office, spread across only 65 distinct home offices. A further 213 have a private equity owner and 695 a holding company owner, out of 5,105 organizations in the ownership file. These sub groups overlap each other.
The large providers
Few in number and enormous in weight. A provider at this scale runs its own clinical standards, has the volume to ask for something built rather than sold, and is the only group where a formulary conversation is likely to involve data rather than anecdote. They are also the hardest to move, because whatever they have now is deeply wired into their workflow, and any change has to survive a committee that includes people who were not in the room when the relationship started.
Who decides: a committee. Clinical leadership, the medical director and finance together, sponsored by an operations executive.
388
providers served 1,000 or more distinct beneficiaries in the 2024 reporting year. A further 578 served between 500 and 999.
Non profit and government providers
A genuinely different buyer, not a smaller version of the same one. Decisions run through boards, committees and sometimes a formal procurement process, the timeline is set by a meeting calendar rather than by urgency, and the argument that lands is continuity and quality of care rather than efficiency. The approach that works on an owner operator can read as pushy here, and the same message sent to both groups will underperform in one of them without telling you which.
Who decides: the executive director with a board or finance committee behind them, on the committee's schedule.
946
certified locations state non profit, government or a government and non profit combination. Ownership is not stated at all for 1,560 of the 6,669 certified locations, so the true figure is higher and cannot be pinned down from the file.
Recently certified hospices, the only group with no incumbent
The most actionable row on the page. A hospice certified in the last two or three years is standing up its clinical operation from nothing, and the pharmacy relationship is a decision it is making for the first time rather than one it would have to unpick. Every other row on this page requires displacing somebody. This one does not. It is also the row with a closing window, because the certification wave of the early twenty twenties has clearly slowed and the cohort is shrinking year on year.
Who decides: the founder or administrator, directly, while they are still building the operation.
823
certified locations were certified in 2023, 2024 and 2025 together, at 375, 255 and 193. The comparable figures for 2021 and 2022 were 686 and 723, so the annual cohort is about a quarter of what it was.
The people layer, which this page refuses to count
Organizations can be counted exactly. People in roles cannot, and this is where most market maps quietly start estimating. No public register lists hospice staff by job title, and the commercial databases that appear to do it are matching on text rather than on fact: a control check run while building this page returned more than two thousand scuba instructors, pastry chefs and zookeepers apparently working at US hospice organizations. So the roles named against each row above are the structure of the decision, established from how these organizations are actually run. They are not a counted population, and any supplier who hands you a precise headcount for a role in this market has estimated it.
The seats that matter: owner or executive director, director of nursing or clinical services, the hospice medical director, finance, quality and compliance, and in multi site groups a regional operations lead.
No honest public count
Named people are built one organization at a time, by hand. This layer is on the page because leaving it out would make the map look more complete than it is.
The market by size, which does add up
Unlike the groups above, these bands are mutually exclusive and do sum to the total. Every provider with a 2024 utilization record appears in exactly one of them. This is the single most useful cut on the page, because it tells you how much of the market is reachable by one seller and how much needs a committee.
Distinct beneficiaries served in 2024ProvidersShare
1,000 or more3886.3%
500 to 9995789.4%
250 to 49995715.6%
100 to 2491,48824.3%
1 to 992,72344.4%
All providers with a 2024 record6,134100%
Where they are
Certified locations are not spread evenly, and two states hold close to half of them. A national field approach and a two state approach are very different businesses.
StateCertified locationsShare of all
California1,91328.7%
Texas1,05315.8%
Georgia2613.9%
Arizona2373.6%
Nevada1832.7%
Pennsylvania1792.7%
All other states and territories2,84342.6%

Where the openings are

1
Sixty five home offices sit above three hundred and ten organizations. That is the shortest high value list in this market by a wide margin. Every one of those 65 is a single named conversation that carries multiple sites with it, and the seat that owns it is a corporate operations or finance lead rather than anyone at the site you might already visit. Most suppliers in this market work the sites, because the sites are who they meet. Working the home offices instead is a different motion, a much smaller list, and it is the one that changes a number rather than adding to it.
2
The only row where you are not displacing anybody is shrinking. Roughly 820 hospices were certified across 2023, 2024 and 2025, and each one chose a pharmacy arrangement for the first time with no incumbent to remove. The annual cohort has fallen from 723 in 2022 to 193 in 2025. A new certification is a dated, public event, so this group can be watched as it happens rather than found afterwards, and reaching one in its first months is a fundamentally easier conversation than reaching it in year three. The window on the whole segment is closing.
3
Two states hold 44 percent of the market and are almost certainly not getting 44 percent of anyone's attention. California and Texas together hold 2,966 of 6,669 certified locations. The rest is scattered thinly across 53 other states and territories, where a field based approach spends most of its effort traveling. That split argues for two different motions rather than one national one, and the thin half is where a reach based approach beats a presence based approach outright, because presence there is not affordable for anyone.
Built from public federal program files covering hospice certification, hospice utilization and ownership disclosure, each pulled in full on 21 September 2026 and each reconciled against its own declared row count. Three files, three different bases, and they deliberately are not forced to agree: 6,669 counts certified locations on the current roster, 6,134 counts providers with a 2024 utilization record, and 5,105 counts organizations appearing in the ownership file. A multi site operator therefore appears once per location in the first and once as an organization in the third. The groups above overlap and must not be added together, though the size and state tables do sum. Utilization is the 2024 reporting year, the most recent published. Certification proves enumeration only, never size, quality or activity, and a layer with no credible public number says so here rather than showing one.
ENQUIRER CONSULTING GROUP
enquirerconsulting.com