How much is a home care agency worth?

Short answer: a licensed agency with a stable caregiver roster and private-pay clients sells around 3× owner earnings in realized deals — solid for a labor business — because the census renews weekly and demand never cycles down. A thin roster and a Medicaid-heavy census pull the same agency well below that. See Home Care, then run your census through the valuation calculator.

The number

Realized data, with the category named exactly: BizBuySell's industry multiples (closed sales, trailing five years through Q2 2026) put Home Health Care Businesses at 3.00× SDE and 0.63× revenue, median sale price $692,000. BizBuySell's category spans non-medical home care through skilled home health, so treat it as the realized neighborhood for care agencies — your position in it depends on payer mix and staffing, below. The IBBA Market Pulse (Q2 2026) size ladder runs across all small businesses: 2.0× SDE under $500K, 2.8× at $500K–$1M, 3.1× at $1M–$2M, then EBITDA multiples — 4.8× at $2–5M and 5.8× at $5–50M. For scale context only: public companies in Damodaran Online's Healthcare Support Services bucket (January 2026) trade at 11.17× EV/EBITDA. That is a proxy ceiling for large, liquid companies — not your price. A small private business sells at a steep discount for size, illiquidity, and owner risk.

Worked example, math shown:

• Revenue (assumption — a mid-size agency billing roughly 900 care hours a week): $1,200,000
• SDE margin (assumption — care margins are thin by design): 18% → SDE = $1,200,000 × 0.18 = $216,000
• Price at the realized multiple: $216,000 × 3.00 = $648,000
• Revenue cross-check: $1,200,000 × 0.63 = $756,000

Buyers price risk and opportunity cost. In home care the risk walks on two legs: caregivers quit, and clients' hours end. The whole valuation conversation is about how fast either happens.

How buyers actually value a home care agency

The asset is the active census plus the roster that serves it — and buyers audit both like a staffing business, because that's what it is. First, payer mix. Private-pay hours bill at market rates with margin you control. Medicaid waiver hours bill at state-set rates that barely move while wages climb every year; long-term-care insurance sits in between, lucrative but paperwork-heavy. Two agencies at $1.2M revenue price very differently at 80% private-pay vs. 80% Medicaid. Second, caregiver turnover. Industry turnover runs brutally high — north of 60% annually in many surveys — so an agency holding turnover well below that owns something rare: continuity families notice and referral sources reward. Buyers will pull your roster tenure data. Third, client concentration in hours: a census of 60 clients averaging 15 hours a week is a portfolio; three 24/7 cases are three points of failure, each needing five caregivers to staff. Fourth, licensing and compliance: the state home-care license, EVV (electronic visit verification) records, caregiver credentialing files, and any survey deficiencies. In many states the license transfer or change-of-ownership process is the deal timeline — a buyer literally cannot operate without it, so clean compliance is priced like an asset, not a checkbox.

What raises the price — and what kills it

Raises it:

• Private-pay share growing year over year, with rate increases clients have already absorbed
• Caregiver turnover measurably below market, with tenure data to prove it and a waitlist bench for call-offs
• Multiple referral sources — hospitals, elder-law attorneys, senior communities — none above a third of new clients
• Clean state surveys, EVV compliance, and a scheduler/care coordinator who stays

Kills it:

• Medicaid-rate dependence in a state that hasn't raised rates while your wage floor rises annually
• A census built on two or three 24/7 cases — lose one family and you lose a quarter of revenue on a phone call
• Caregivers who are really the owner's personal hires, loyal to her, undocumented in any system
• Open compliance findings, lapsed credentials, or EVV gaps — in a regulated business these transfer to the buyer

Move your number

Three levers:

• Stabilize the roster and the census with operations, not heroics. Call-off coverage systems, caregiver check-ins, family update calls, and referral-source follow-up that happen on schedule — the ClaroPro team builds that coordination layer so continuity survives the owner's vacation, let alone her exit.
• Collect private-pay without the monthly fight. Cards on file and scheduled ACH for family payers, invoiced weekly instead of monthly, cuts the receivables drag that eats care margins. That's a Finix payments team conversation.
• Put scheduling and compliance on real systems. EVV, credential tracking, and care-plan documentation that a buyer (and a state surveyor) can audit in an afternoon — a Nova engineering team can integrate your scheduling, billing, and HR systems so the data agrees everywhere.

Run your hours and payer mix through the calculator, prefilled for home care.

This is an educational framework with shown math, not an appraisal. A real price is set by a real buyer on a specific day — in this trade, after they've verified your license, your roster tenure, and your payer mix in the actual files. These caveats exist to protect the owner: they keep you from overpaying for a census that's about to churn, underselling one that's stable, or inheriting compliance findings you didn't create. Never invent. Show the math. We're on the side of the business owner.