Home Healthcare Services

The 28,200 home healthcare service providers in the US offer skilled nursing and other types of health-related services in the home. Major service categories include traditional home healthcare services (with or without rehabilitative services), home hospice care, home nursing care, homemaker and personal care, home infusion therapy, and the rental or lease of goods and/or equipment. Companies may specialize in a particular service, such as respiratory therapy or hospice care.

Dependence On Third Party Payers

Home healthcare services providers are dependent on third party payers, including Medicare, Medicaid, private insurance companies, and managed care organizations, as sources of revenue.

Risk Of Malpractice

The inherent risk in providing healthcare outside a traditional setting exposes companies to the risk of malpractice.

Sep 1, 2026 - Federal Fraud Investigators Target Push Toward At-home Care

• The Trump administration is citing the rapid growth of California’s in-home services as evidence of fraud, according to the NOTUS news organization. The Trump administration is withholding more money from California than any other single health program in the country. About $2.2 billion in Medicaid funds intended for the state have been paused. About $1.7 billion is for California’s In-Home Supportive Services. Dr. Mehmet Oz, administrator of the Centers for Medicare and Medicaid Services, said in July that spending on in-home programs increased 24% in California over the last two fiscal years, compared with 12% on average for the rest of the country. California officials told NOTUS that they are complying with CMS’s requests for more information as the agency evaluates its funding.
• Broad changes to Medicaid, including $911 billion in reductions to federal spending and Medicaid work requirements, could have implications for the direct care workforce in both home care and institutional care settings given Medicaid’s outsized role in long-term care spending and relatively high Medicaid coverage rates among direct care workers, according to health policy research firm KFF. Direct care workers may also feel the impacts of recent changes in immigration policy. Three in ten direct care workers are immigrants, including naturalized citizens and noncitizens, who include lawfully present and undocumented immigrants. Two proposed rules from the Department of Labor may also have an impact on direct care workers. One rule would roll back minimum wage and overtime protections for home care workers. The other rule would make it easier for employers to classify direct care workers as independent contractors, which would strip them of some labor protections.
• About 56% of home-based care providers who responded to a 2026 survey conducted by Home Health Care News reported that Medicare Advantage (MA) is the payer type exerting the most pressure on their organizations. That's nearly twice the rate of the next-closest payer, Medicaid, at 31%. Low reimbursement rates were cited as a top-two MA challenge by 56% of respondents. General administrative burden was the other top two challenge associated with Medicare Advantage for 43.8% of respondents. Prior authorizations and delays were among the top challenges for 37.5% of respondents, as were denials. Home-based care providers are facing reimbursement challenges on multiple fronts, according to Home Health Care News. The 2026 home health final payment rule, Medicaid funding cuts from the One Big Beautiful Bill and more have companies increasing their advocacy efforts, leaning into their strengths to navigate choppy reimbursement waters, and considering layoffs, according to Home Health Care News. Healthview CEO Steven Gonzalez told Home Health Care News that he is aware of the dangers of a 1.3% cut to home health payments. This is why the company spent time advocating on behalf of the industry on Capitol Hill in August 2025. CMS estimates that total Medicare payments to home health agencies will decrease by $220 million in 2026 compared to 2025, a net reduction of 1.3%. This reflects a 2.4% payment update offset by multiple downward adjustments, including permanent and temporary behavioral offsets and outlier recalibrations.
• Home healthcare industry employment and average wages for nonsupervisory employees increased slightly during the first six months of 2026, according to the US Bureau of Labor Statistics (BLS). Home healthcare services increased prices slightly during the first seven months of 2026, according to the BLS. Industry sales are forecast to increase at a 6.44% compounded annual rate from 2024 to 2028, faster than the growth of the overall economy, according to Inforum and the Interindustry Economic Research Fund, Inc.

Industry size & Structure

The average home healthcare services provider operates out of a single location, employs about 62 workers, and generates $4 million in annual revenue.

• The home healthcare services industry consists of about 28,200 firms that employ 1.8 million workers and generate $113.4 billion annually.
• The industry is fragmented; the top 50 firms account for 33% of industry sales.
• Large companies include Apria Healthcare, Lincare Holdings, Amedisys, and Kindred at Home (formerly Gentiva Health Services).