Home Health & Hospice
Agencies and programs delivering skilled nursing, personal care, hospice, infusion therapy, and rehabilitation services in home and community settings.
- 6
- Segments
- 22
- Verticals
Overview
Home Health & Hospice covers care delivered in the home — Medicare-certified skilled home health, hospice and palliative care, home infusion, personal care and home-aide services, and private-duty nursing. It is one of the most consolidated and invested-in themes in healthcare, riding the structural shift of care from facilities to the home.
Aging demographics, the cost advantage of home-based care, and Medicare Advantage incentives drive strong growth. Payers have vertically integrated into home health (UnitedHealth/Optum and Humana/CenterWell), private equity has rolled up hospice and personal care, and antitrust scrutiny (the UnitedHealth–Amedisys deal) has accompanied the consolidation.
Market snapshot
- Market size
- ~$243B
- Growth
- ~7.6%CAGR (2017–22, nominal)
- Companies
- ~90,179 firms
71.2% of firms have fewer than 20 employees: 64,214 micro-businesses, below most mandates.
- 20–99
- 17,97269%
- 100–499
- 6,08323%
- 500+
- 1,9107%
One of healthcare's most consolidated themes — ~90,000 firms riding the structural shift of care from facilities into the home. Aging demographics, the cost advantage of home-based care, and Medicare Advantage incentives drove ~7.6%/yr growth; payers have vertically integrated (Optum, CenterWell) and PE has rolled up hospice and personal care. The count spans skilled home health, hospice, and the labor-heavy personal-care base — the latter's smaller agencies pull the average firm size down.
NAICS 621610, 624120, 624190. U.S. Census Bureau — 2022 Statistics of U.S. Businesses; U.S. Census Bureau — 2022 Economic Census.
Business model & economics
Revenue model
Medicare/Medicaid reimbursement plus private-pay home care
Key economics
- Revenue per firm
- $2,699,389
- Revenue per employee
- $68,352
- Employees per firm
- 37.1
- Recurring revenue
- High
- EBITDA margin
- 10–20%
- Capex intensity
- Low
recurring, episodic and ongoing home care
Characteristics
- Balanced cost base — payroll is 47% of revenue, leaving room to scale margin without cutting staff
- Deep strategic-buyer pool — 1,910 firms exceed 500 employees, so a scaled asset has trade buyers
- Structural shift of care from facilities to the home.
- Payers vertically integrating into home health.
- PE rolling up hospice and personal care.
NAICS 621610, 624120, 624190. U.S. Census Bureau — 2022 Statistics of U.S. Businesses; U.S. Census Bureau — 2022 Economic Census.
M&A deal context
Who’s acquiring
- Payer-aligned home-care platforms
- PE-backed home-care & hospice consolidators
- Home-based-care strategics
What’s driving deals
- Payer vertical integration into home health.
- PE roll-up of hospice and personal care.
- Aging-demographic and care-shift demand.
Segments in this industry
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