The majority of the US home health market is dominated by only one or two owners.
A study recently published in Jama Network Open shows that this high concentration is caused by the healthcare system of home healthcare providers and the acquisition of corporate investors.
As part of the study, the researchers analyzed 5,884 Medicare-certified home health institutions. The sample included 3,823 agents in 256 metropolitan markets and 2,061 aircraft in 518 non-met markets.
In total, 694 agents partnered with the health system, with 2,216 having corporate owners.
Overall, 23% of Metropolitan and 56% of non-Metropolitan markets had one or two owners, accounting for the overall home health market.
Additionally, 70% of the Metropolitan and 93% of the non-Metropolitan market had fewer than two owners, making up half of the market.
“Health systems and corporate investors are increasingly being acquired (home healthcare institutions),” the researchers wrote. “Acquisitions may facilitate adjustments in care, but fewer owners control the market and increasing concerns about the quality of home health services and spending.”
Aside from corporate investors, private equity investors continue to be interested in home care spaces. In 2025, PE accounted for more than half (over 61%) of all home care transactions.
Dexter Braff, founder and president of the healthcare M&A advisory firm The Braff Group, repeated this discovery in Behavioral Health Business', Invest Conference, a sister publication of Home Health Care News.
“Private equity needs to be purchased and they need to buy quickly,” Bluff said. “There's a very high chance that 2025 will be a big spike.”
More broadly, home care spaces were sites to increase integration.
In 2021, Atlanta-based technology company LexisNexis Risk Solutions discovered that the top 10 home health providers in space account for more than 25% of the national market share. At the time, the list of dominant home health athletes included Bayada Home Health Care, Elara Caring, Trinity Health at Home and AccentCare.
