4.6.5Segment

Personal Care & Home Aide Services

Home care agencies providing non-medical personal care, companionship, and homemaker services to elderly and disabled clients.

4
Verticals

Overview

Personal Care & Home Aide Services covers home-care agencies providing non-medical personal care, companionship, and homemaker services to elderly and disabled clients. It is the largest home-care category, blending private-pay and Medicaid-funded care, and one of the fastest-growing.

Demand is propelled by the aging population, the preference to age in place, and the labor-intensive nature of personal care, with persistent direct-care workforce shortages the central challenge. It is a highly fragmented market (Home Instead, Comfort Keepers, and many local agencies) seeing heavy franchise and private-equity consolidation, plus tech-enabled entrants (Honor, Papa).

Market snapshot

Market size
~$129B
Growth
~9.0%CAGR (2017–22, nominal)
Companies
~61,981 firms
Firms by employee count

73.9% of firms have fewer than 20 employees: 45,813 micro-businesses, below most mandates.

The investable universe16,168 firms with 20+ employees
20–99
10,92368%
100–499
4,10025%
500+
1,1457%

The largest and fastest-growing home-care category (~9%/yr) — ~62,000 mostly small agencies providing non-medical personal care and companionship, blending private-pay and Medicaid funding. Aging-in-place demand runs into persistent direct-care workforce shortages, the binding constraint on margin. The figure leans partly on a broad 'other individual & family services' bucket, so it modestly overstates pure personal care.

NAICS 624120, 624190. U.S. Census Bureau — 2022 Statistics of U.S. Businesses; U.S. Census Bureau — 2022 Economic Census.

Business model & economics

Revenue model

Private-pay and Medicaid hourly personal-care fees

Key economics

Revenue per firm
$2,085,165
Revenue per employee
$64,580
Employees per firm
28.7
Recurring revenue
High

recurring ongoing care

EBITDA margin
10–18%

labor-constrained

Capex intensity
Low

Characteristics

  • Balanced cost base — payroll is 46% of revenue, leaving room to scale margin without cutting staff
  • Deep strategic-buyer pool — 1,145 firms exceed 500 employees, so a scaled asset has trade buyers
  • Largest and one of the fastest-growing home-care categories.
  • Aging-in-place demand against direct-care workforce shortages.
  • Heavy franchise and PE consolidation; tech-enabled entrants.

NAICS 624120, 624190. U.S. Census Bureau — 2022 Statistics of U.S. Businesses; U.S. Census Bureau — 2022 Economic Census.

Geographic concentration

AlabamaAlaskaArizonaColoradoFloridaGeorgiaIndianaMaineMassachusettsNew JerseyNorth CarolinaNorth DakotaOklahomaPennsylvaniaSouth DakotaTexasWyomingConnecticutWest VirginiaIllinoisNew MexicoArkansasCaliforniaDistrict of ColumbiaHawaiiIowaKentuckyMarylandMichiganMississippiMontanaNew HampshireNew YorkOhioOregonTennesseeUtahVirginiaWashingtonWisconsinNebraskaSouth CarolinaIdahoNevadaVermontLouisianaRhode IslandKansasMinnesotaMissouriDelaware

Personal care and home-aide agencies concentrate heavily in Missouri — whose consumer-directed Medicaid program supports an outsized agency base — alongside Delaware, Minnesota, and Kansas, tracking state Medicaid home-care funding and aging populations.

MissouriDelawareMinnesotaKansas

U.S. Census Bureau — 2022 Statistics of U.S. Businesses (firms by state), NAICS 624120/624190. Concentration shown by location quotient.

M&A deal context

Deal activityHigh

Who’s acquiring

  • Home-care franchise networks
  • PE-backed personal-care platforms
  • Tech-enabled home-care entrants

What’s driving deals

  • Franchise and PE roll-up of local agencies.
  • Aging-in-place demand.
  • Workforce shortages shaping economics.

Verticals in this segment

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