50 STATES OF CARE -NORTH CAROLINA
North Carolina Home Care: 2025 Overview
North Carolina’s non-medical home care industry is growing rapidly, driven by an aging population, Medicaid programs, and evolving caregiver models. For healthcare operators, understanding staffing, reimbursement, and regulatory frameworks is critical — especially for those looking to improve their business with the intention to exit, adding value in the areas buyers care most about. If you have any questions about selling your healthcare business at a premium, contact Jake@acquire.care for guidance.
Industry Growth
As of 2025, North Carolina has roughly 16,624 home care businesses, with the sector growing at an average of 4.6% annually since 2020. The senior population is increasing, which will continue to drive demand for home care services over the next decade.
Pay & Rates
The average hourly rate for non-medical personal care is about $28/hour, though caregivers earn a median of $9.84/hour, below living wage standards. Recent initiatives aim to increase wages by $6.50/hour to reach $18/hour, improving retention and service quality — a critical factor when optimizing your business for future sale.
Medicaid Waivers
North Carolina administers several Medicaid Home and Community-Based Services (HCBS) waivers:
NC Innovations Waiver: Supports individuals with I/DD.
CAP/DA: For disabled adults needing community support.
CAP/C: Tailored for children.
1915(i) Waiver: Respite, employment support, and community living assistance.
These programs increase client satisfaction and create revenue streams — a key value driver for buyers.
Managed Care
North Carolina transitioned to Medicaid Managed Care, with MCOs coordinating care and reimbursement:
Carolina Complete Health
UnitedHealthcare Community Plan of NC
WellCare of NC
AmeriHealth Caritas NC
Healthy Blue
Understanding these MCOs is essential for compliance and maximizing your agency’s value prior to sale.
PACE & Caregivers
PACE serves seniors 55+ eligible for nursing home care but preferring community-based care, with 12 centers statewide. Family caregivers are compensated through Medicaid waivers at $10–$15/hour, supporting in-home care delivery — another area that can add value for potential buyers.
Major Players
Major providers include CenterWell Home Health and Atrium Health/Advocate Health, both with extensive statewide operations.
Key Takeaways
North Carolina’s home care market offers strong growth potential, but success requires attention to staffing, retention, and navigating Medicaid MCOs and waivers. For owners planning an exit, focusing on these operational and compliance areas adds tangible value in the eyes of buyers.
If you want to explore how to position your healthcare business for maximum premium sale, reach out to Jake@acquire.care — expert guidance ensures your agency is optimized for growth and buyer appeal.
Quick Data (2025)
Caregiver turnover: ~75–80%
59% of agencies report insufficient staff
Median annual wage: ~$34,900
Workforce: 4.3M → 5.1M projected by 2034
~765,800 annual job openings
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