Private equity vs strategic buyer: which is right for your home care agency?

What is the difference between a strategic buyer and private equity in home care?

A strategic buyer operates home care and buys your agency to add clients, caregivers, referral sources and markets to a business it plans to keep. A private equity fund buys agencies as an investment it expects to sell, usually within three to six years. In home care the two overlap, because many of the operators buying small agencies are themselves owned by a fund: an operator with a sponsor's capital and a sponsor's exit clock.

There are five kinds of acquirer you will meet, and the label matters less than who funds the deal and what they plan to do with your agency in five years.

Public strategics

Addus HomeCare, Aveanna, BrightSpring and Pennant, plus UnitedHealth's Optum, which bought Amedisys for about $3.3 billion. They pay from cash and credit lines and keep what they buy. Enhabit was in this group until Kinderhook Industries, a private equity firm, took it private in May 2026, a reminder that a strategic's owner can change too.

PE-backed platforms buying add-ons

Home care companies owned by a fund, such as Help at Home (bought by Centerbridge and Vistria in 2020), which tied for the most home health and hospice deals in 2025 with four, or Avid Health at Home, which completed its eighth tuck-in in August 2026. They usually ask you to roll part of the price into their equity.

PE funds buying a new platform

A fund buying its first home care company. Most are large, like TEAM Services at about $3 billion, but a fund can also start small: Havencrest formed Avid Health at Home in 2023 by buying one Chicago-area non-medical home care agency, For Papa's Sake Home Care.

Regional private operators

Family-owned or founder-led agencies expanding into the next county or state. Often the simplest buyer, sometimes a competitor you already know.

Independent sponsors and search funds

Individuals or small teams who raise equity deal by deal. Their financing is not committed until they find you, so certainty of closing is the first thing to test.

Do strategics or private equity pay more for a home care agency?

Neither pays more as a rule. They justify the price in different ways, and the higher bid usually comes from whichever buyer wants your market most.

A strategic already serving your county can close your office, move billing and payroll onto its own staff, and run your schedulers on its system. Those savings let it pay a higher multiple of your EBITDA while paying a lower multiple of what your agency will earn inside its company. A strategic with no overlap in your market has fewer savings to pay you with.

A PE-backed platform prices on the gap between small and large company multiples. Scope Research puts the median for home-based care deals under $10 million of enterprise value at 4.7 times EBITDA. At the other end, Bloomberg reported that General Atlantic paid about 10 times EBITDA for TEAM Services in 2026. A platform that buys agencies near the first number and expects to sell near the second can bid hard for a clean, growing agency. That same gap is why it asks you to roll equity: much of its return arrives at the next sale.

What happens to your caregivers, office and brand after closing?

Caregivers and nurses almost always stay, because they are what the buyer is paying for. The changes land on the back office: payroll, billing, EMR and scheduling software, HR and accounting usually move to the buyer's systems within months, whoever buys you.

The difference is in how far integration goes. When BrightSpring bought home health and hospice locations divested in the UnitedHealth and Amedisys deal in 2025, it said it would retain all employees, and its CEO said it planned to apply some of its payer contracts, IT and people practices to them. Pennant runs each operation under local clinical and operational leaders while its Service Center handles accounting, payroll, HR, IT and legal. A strategic in your own market is the buyer most likely to merge offices and retire your name. A platform entering a new state often keeps your local brand and leadership, at least until it has enough agencies there to consolidate.

Should you take rollover equity from a PE-backed platform?

Take it if you could live with losing the rolled amount and you believe in the platform more than in your own agency. Your rolled stake no longer depends on your agency; it depends on the platform's growth, its debt and the multiple at its next sale, none of which you control.

Rollover is how sellers to PE get a second bite of the apple, and platforms do change hands: Wellspring bought Help at Home in 2015, sold it to Centerbridge and Vistria in 2020 while keeping a minority stake, and its new owners were reported in December 2023 to be weighing a sale that could value it at $3 billion or more. The worked example below shows how the same rollover can nearly triple or go to zero. Your M&A attorney and CPA should review the equity documents and the tax structure before you sign a letter of intent.

Which buyer should you choose?

Start with what you want the day after closing, then pick the buyer type. Owners who want to retire and take the most cash now usually do best with a strategic or a regional operator paying cash. Owners who want to keep running the agency and believe home care will keep consolidating usually do best with a PE-backed platform and a rollover. Owners whose priority is their staff and name should ask each buyer what it did with the last three agencies it bought, then call those owners.

Recent home care deals by buyer type

Most home care deals are small and never disclose a price. LevinPro HC counted 110 home health and hospice deals announced in 2025, mostly smaller tuck-ins. PE firms or their portfolio companies were in about 37 percent of them; strategic and regional operators did the majority. So expect to hear from both kinds of buyer. The larger deals below are public because a listed company had to report them, and they show how each buyer type pays and what it buys.

Side by side: strategic vs PE-backed platform

These are typical patterns, not rules. A specific buyer's answers to the questions further down matter more than its category.

Worked example: 25 percent rollover into a PE-backed platform

All figures are illustrative and simplified: no taxes, fees, escrow, working capital adjustments, preferred returns or dilution from later capital raises.

Your agency has $1,000,000 of adjusted EBITDA. A platform offers 5 times, or $5,000,000, with 25 percent rolled. You take $3,750,000 in cash and roll $1,250,000. The platform has $20 million of EBITDA, an enterprise value of $200 million and $100 million of debt, so its equity is worth $100 million and you own 1.25 percent. Five years later it has borrowed more to buy agencies and carries $130 million of debt when it is sold.

Which buyer fits your goal

Most owners have two goals that pull against each other. Rank them before you meet buyers, so a strong first offer does not decide for you.

Questions to ask each buyer before you engage

Ask these before you share your full financials. A buyer that answers them plainly and offers references is usually one worth meeting.

How Lartico Capital fits in

Lartico Capital introduces you to screened buyers one at a time. You decide which ones to talk to, and your name is shared only after you approve a buyer and it signs an NDA. That lets you put a strategic's cash offer next to a platform's cash-plus-rollover offer before you commit to either. Lartico Capital is free for owners, and it is not a broker or an advisor, so pair it with your own attorney and CPA.