Selling your home health agency?
Payor mix decides your multiple.

The honest version

What home health businesses actually sell for

Agencies commonly trade in the range of 6–10x adjusted EBITDA, with Medicare-certified and licensure-protected agencies at the top of the range. Private-pay home care businesses are valued on different fundamentals than Medicare-certified home health, and the two should never be benchmarked against each other.

The range is wide because the same business is worth different amounts to different buyers. In this sector you are usually looking at three:

• PE-backed care platforms — the most active buyers, typically the strongest bidders for certified agencies in favourable regulatory markets.
• Regional strategics and health systems — buying for referral control and geographic coverage.
• Individual and regional operator buyers — realistic for smaller private-pay agencies.

Which of those is at your table changes your number far more than anything on your equipment list.

What moves the number

The four things buyers actually underwrite

• Payor mix. Medicare, Medicaid, managed care, and private pay each carry different margins and different risk, and buyers underwrite each separately rather than looking at blended revenue.
• Licensure and certificate-of-need position. In CON states, the licence itself carries substantial value because it limits competition. This is often the largest single component of the price.
• Caregiver recruitment and retention. Census growth is limited by staffing, so demonstrated ability to hire and hold caregivers is a direct driver of value.
• Survey and compliance history. A clean survey record is a prerequisite for institutional buyers; deficiencies are a pricing and sometimes a viability issue.

The sector-specific factor to prepare for is regulatory diligence. Buyers will examine your survey history, billing compliance, and documentation practices closely, and change-of-ownership processes can extend timelines significantly. Starting the compliance clean-up well before a process begins is not optional in this sector.

The process

Why a quiet, competitive process beats the first offer

Most owners in this sector are approached directly, unsolicited, by a consolidator or a platform buyer. That approach is flattering and it is also the single most expensive letter you can accept, because a buyer negotiating against nobody has no reason to move on price or on terms.

We run the opposite process. Buyers are qualified and under confidentiality agreement before they learn whose business it is. Nothing is listed, advertised, or published. Your staff, your customers, and your competitors learn nothing until you decide they should — and several credible buyers are considering the same opportunity at the same time.

The result is not only a better number. It is better terms: what happens to your team, how long you stay, how the earn-out is structured, and what happens to any real estate.

Common questions

Home health agency owners ask us these first

What is my home health agency worth?

Home health and home care agencies commonly sell for 6 to 10 times adjusted EBITDA. Medicare-certified agencies and those holding licences in certificate-of-need states sit at the top of the range. Payor mix, caregiver retention, and survey history drive the number.

Who buys home health agencies?

Private-equity-backed care platforms are the most active buyers, along with regional strategics and health systems buying for coverage and referral control, and individual operators for smaller private-pay agencies.

How long does it take to sell a home health agency?

Longer than most sectors, because change-of-ownership and licensure processes add time after the commercial terms are agreed. Planning for a longer runway, and having compliance documentation in order before you start, is the way to avoid delays that cost value.