For home health & home care owners · US & Canada
Agencies that look similar on revenue can be valued very differently depending on who pays the bills and what licences you hold.
In short
Small owner-run home health and home care agencies typically sell for about 2–3.5x seller’s discretionary earnings (SDE). Agencies with roughly $1M+ of EBITDA trade around 5.5–8.5x EBITDA, with Medicare-certified agencies and those holding licences in certificate-of-need states at the upper end, and platform-scale deals 9–12x. These are market ranges, not a quote or a guarantee. Payor mix, caregiver retention, and survey history drive the number.
The signature question in home-based care
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.
Certified-agency value, and the reimbursement-change scenarios buyers model.
Program rates and rules, underwritten for what could change.
Contract terms, payer by payer.
Valued on different fundamentals — never benchmarked against certified home health.
Illustrative — your own mix is what a buyer will model, line by line.
Licensure & survey readiness
Buyers will examine your survey history, billing compliance and documentation practices closely, and change-of-ownership processes can extend timelines significantly. Start well before a process begins.
In CON states the licence itself carries substantial value because it limits competition — often the largest single component of the price.
A clean survey record is a prerequisite for institutional buyers; deficiencies are a pricing and sometimes a viability issue.
Buyers examine billing compliance and documentation practices closely in regulatory diligence.
Census growth is limited by staffing, so a demonstrated ability to hire and hold caregivers drives value directly.
Referral control is part of what strategic buyers pay for — and concentration is one of the first questions they model.
CHOW and licensure processes add time after the commercial terms are agreed. Plan the runway before you start.
What agencies actually sell for
Payor mix, caregiver retention and survey history drive the number. Private-pay home care is valued on different fundamentals than Medicare-certified home health.
| Agency profile | Basis | Typical range |
|---|---|---|
| Small, owner-run agency | SDE | 2–3.5× |
| ~$1M+ EBITDA — Medicare-certified and licensure-protected agencies at the upper end | EBITDA | 5.5–8.5× |
| Platform-scale deals | EBITDA | 9–12× |
Market ranges, not a quote or a guarantee. Get your own range in 60 seconds.
Who buys home health agencies
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Straight answers
More in our guide to selling without employees knowing.
Small owner-run home health and home care agencies typically sell for about 2–3.5x seller’s discretionary earnings (SDE). Agencies with roughly $1M+ of EBITDA trade around 5.5–8.5x EBITDA, with Medicare-certified agencies and those holding licences in certificate-of-need states at the upper end, and platform-scale deals 9–12x. These are market ranges, not a quote or a guarantee. Payor mix, caregiver retention, and survey history drive the number.
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.
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.
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