What Public Home Care Companies Are Signaling — And What It Means for Main Street Buyers & Operators
If you’re buying or operating a home-based care business in the lower middle market, the best leading indicators don’t always come from private deals — they come from the public companies. Their earnings calls are effectively macro roadmaps for everyone else.
Across home care, home health, pediatric skilled nursing, and home infusion, the most recent public-company reports are packed with good news: rising rates, improving hiring trends, stronger payer relationships, and expanding census. For buyers and owners, these trends translate directly into higher valuations, more predictable EBITDA, and stronger forward cash flow.
Below is what the top publicly traded operators are experiencing — and how it maps to the realities of smaller operators in the field today.
If you want deal-specific insight for your market, reach out anytime at jake@acquire.care.
📈 Addus HomeCare (ADUS): Medicaid Rate Lift & Hiring Momentum
Addus continues to show how reliable Medicaid personal care can be when states push rate increases. Illinois and Texas have already moved forward with meaningful reimbursement bumps — and Addus’ earnings show the effect immediately in 25%+ revenue growth and a 30%+ jump in EBITDA.
What this means for lower-middle-market buyers
Personal care agencies in states with rising Medicaid rates become high-conviction acquisitions.
When labor supply improves (Addus reported its best hiring cadence of the year), smaller agencies benefit first — faster staffing equals faster revenue capture.
Buyers are increasingly paying premiums for agencies with clean payer mixes and hard-to-replace Medicaid contracts.
What this means for owners
A rate increase in your state is more than a budget line — it’s a valuation event. If you’ve secured consistent staffing and hours delivered, that is exactly what groups like ours look for.
If you’re considering timing your exit around rate momentum, send me a note at jake@acquire.care.
🩺 Aveanna Healthcare (AVAH): High-Acuity Care Scaling Through Medicaid
Aveanna’s earnings were some of the strongest in the sector — 22% revenue growth, 67% EBITDA growth, and multiple wins across Medicaid in 8–10 states. They also signed new preferred payer arrangements for private duty nursing.
Implications for buyers
High-acuity, PDN-heavy agencies are becoming more valuable, not less — especially when tied to Medicaid preferred networks.
States are beginning to pay more for complex care at home, which supports premium valuations for smaller PDN providers in the right geographies.
When public operators lean into states with rate wins, that’s often where acquisition demand rises next.
Implications for owners
If you operate PDN or long-hour skilled nursing, macro conditions finally favor you: better Medicaid pricing, stronger demand, and more stable referral patterns.
This is one of the clearest “green-light” environments for owners considering an exit in 12–24 months.
🏠 Enhabit (EHAB): Contracting Power & Stabilized Census
Enhabit has been stabilizing Medicare home health census while renegotiating large Medicare Advantage contracts — finally pushing MA plans toward better rates.
Implications for buyers
Markets where MA payers have re-priced upward are seeing stronger, more predictable margins.
Smaller home health agencies with clean audits, strong clinicals, and consistent utilization will benefit most from MA rate stabilization.
Implications for owners
If you’ve been squeezed by Medicare Advantage in the past few years, the tide is beginning to turn.
Improving contract economics means your future EBITDA isn’t as compressed — which can materially improve valuation on a sale.
🌄 The Pennant Group (PNTG): Multi-State Growth in High-Demand Regions
Pennant’s 30%+ revenue gains and major acquisition of 54 home health and hospice locations highlight something important: population-growth states are winning.
They operate heavily in the Mountain West, Southwest, and Texas — states with aging populations, strong net migration, and stable reimbursement.
Implications for buyers
If you’re buying in Arizona, Colorado, Idaho, Utah, Nevada, Texas, or Washington, you’re in the slipstream of Pennant’s strategy.
Hospice and home health in these regions remain high-multiple, high-demand assets.
Implications for owners
If your agency is in one of these states, you are sitting on top-tier demographic tailwinds.
These operators don’t invest “just because” — they follow population aging curves, MA penetration, and referral flow.
Your business is part of that macro story.
💊 BrightSpring Health Services (BTSG): Pharmacy + Home-Based Care = Scale Advantage
BrightSpring’s 29% revenue growth and big jumps in specialty pharmacy and infusion services show a trend smaller operators should watch closely:
complex care is moving home, and pharmacy-aligned platforms are taking share.
Why buyers should care
Infusion and specialty-drug–aligned home services are becoming strategic acquisition categories.
Businesses already offering infusion, specialty-trained nursing, or chronic-care support command material premium multiples.
What owners should note
If you have infusion-trained teams or drug-dependent care pathways, you are positioned extremely well for consolidation interest.
This is a good time to evaluate whether you invest to scale — or exit while the market is heating up.
💉 Option Care Health (OPCH): Home Infusion Demand Still Surging
Option Care posted double-digit revenue growth for multiple quarters and reaffirmed strong cash flow guidance. They remain the largest independent infusion provider in the country.
Implications for buyers
Infusion is one of the few home-based care sectors with strong commercial payer tailwinds.
Deals for infusion-capable agencies continue to trade above traditional home health multiples.
Implications for owners
If you provide infusion services — even partial — you are in an in-demand category with national strategic buyers circling.
This is an ideal moment to explore valuation, growth capital, or an outright sale.
Happy to walk through deal structures at jake@acquire.care.
📊 Macro Trends to Watch (That Directly Impact Lower-Middle-Market Deals)
Across the public companies, several macro trends show up again and again. These matter just as much for smaller operators:
1. Rates Are Rising in Key States
Medicaid rate increases in Texas, Illinois, and other states are already elevating valuations for personal care and PDN businesses.
Buyers are now explicitly underwriting state-level rate momentum into forward EBITDA.
2. Hiring Is Finally Improving
Addus and Aveanna both reported the best hiring cadence of their year — and smaller operators feel this first.
When you can staff more hours, your revenue can grow without major overhead.
3. Census Recovery Is Happening
Home health, hospice, PDN, and infusion providers all reported stable or growing census.
For owners, consistent census is a valuation multiplier.
For buyers, it’s evidence that demand is outpacing supply in many markets.
4. Payers Are Repricing High-Acuity Care Upward
Medicaid is paying more.
Medicare Advantage is renegotiating.
Commercial payers are shifting acute infusion home.
These payer shifts create better unit economics for smaller agencies — which directly affects deal feasibility and exit timing.
Final Word: This Is One of the Strongest M&A Windows in Years
If you run a home-based care agency — personal care, PDN, home health, hospice, or infusion — the macro winds are finally blowing in your favor.
Public companies are showing the path. Buyers are following it.
If you want to understand what your agency is worth, which buyers are paying premiums, or how to time your exit around rate cycles, email me anytime:
jake@acquire.care
I’m happy to talk through it — whether you’re buying, selling, or just planning the next chapter.
