HOME CARE

Sell your personal care agency

Non-medical personal care agencies sell on three things: how reliably you staff the hours you are authorized or booked for, how your revenue splits between private pay and Medicaid, and how much of the business runs without you. Buyers now also model the federal Medicaid rule that will require at least 80 percent of Medicaid payments for personal care to go to direct care worker pay from July 2030. Lartico introduces personal care owners to buyers that already operate in this segment, and the buyer pays our fee.

By Akim Guennani, Founder · Updated October 2026

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17%

Projected growth in home health and personal care aide jobs, 2024 to 2034

765,800

Projected annual openings for home health and personal care aides

80%

Minimum share of Medicaid personal care payments for worker pay, from July 2030

What buyers are buying

A personal care agency has few hard assets. What a buyer pays for is a recurring book of clients and hours, a caregiver workforce that can deliver them, and the referral relationships and payer contracts that keep both full. Two agencies with the same revenue can be worth very different amounts depending on how durable those three things are.

Staffed hours: The share of authorized or booked hours you actually fill. Unfilled hours are revenue a buyer cannot count on.
Caregiver retention: Turnover and tenure tell a buyer whether the hours you deliver today will still be delivered next year.
Payer mix: Private pay and long-term care insurance usually carry better margins; Medicaid waiver and managed care bring volume with rate risk.
Owner dependence: If you schedule, recruit, and hold every referral relationship yourself, buyers discount for it or move price into an earnout.

Private pay vs. Medicaid

Buyers do not prefer one payer outright. A private pay agency in an affluent market can command a premium for margin, while a Medicaid-heavy agency with contracts across several plans offers scale and steady authorizations. What gets discounted is concentration: one plan, one county program, or one referral source supplying most of the hours.

Know your numbers by payer before you talk to anyone: revenue, hours, bill rate, and gross margin after caregiver wages and payroll taxes. Buyers build their model from that table.

Franchise agencies

If you operate under a home care franchise, the franchise agreement usually controls whether and to whom you can sell. Expect the franchisor to require approval of the buyer, a transfer fee, and in some cases a right of first refusal. Read the transfer clauses before you start conversations, because they decide which buyers are realistic.

The Medicaid 80/20 rule and your valuation

CMS finalized the Ensuring Access to Medicaid Services rule in May 2024. Starting July 9, 2030, states generally must ensure that at least 80 percent of Medicaid payments for homemaker, home health aide, and personal care services are spent on compensation for the direct care workers who deliver them, rather than on administration or profit. The rule allows states some flexibility, including a separate threshold for small providers and hardship exemptions, and it excludes costs such as travel, training, and protective equipment from the calculation.

Buyers already model this. If your Medicaid business currently spends well below 80 percent of revenue on caregiver compensation, a buyer will ask how margins hold up once your state implements the rule, and whether rates are likely to rise to fund it. Knowing your current percentage, by payer, puts you ahead of that conversation.

Illustrative example: measuring the gap

Assume an agency bills $2,000,000 a year to Medicaid for personal care and spends $1,440,000 on caregiver wages and benefits, or 72 percent. At an 80 percent requirement it would need to spend $1,600,000, a $160,000 difference. If rates do not rise, that comes out of margin, so a buyer would reflect it in price or structure. The figures are hypothetical, and how the rule applies depends on your state's implementation.

Preparing a personal care agency for sale

Most of the preparation is making your operating data easy to verify. Buyers want to see hours, caregivers, and revenue reconcile to each other and to your payroll and billing systems.

Owner checklist

Monthly hours booked or authorized vs. staffed, by payer
Caregiver headcount, turnover, and tenure for the last 24 months
Revenue, bill rate, and gross margin by payer
Caregiver compensation as a share of Medicaid revenue
Top referral sources and their share of new clients
State license or registration, plus any franchise agreement

How Lartico fits in

Lartico works on the buy side. You share your agency's details, we come back with the acquirers in our network that are looking for personal care agencies in your market, and you speak with the ones you choose. There is no listing and no fee to you; the buyer pays our fee at closing.

Sources and methodology

Public transactions provide market context, not a valuation quote for a private practice. Illustrative examples use hypothetical assumptions and are not predictions. This guide is educational and is not legal, tax, accounting, or investment advice.

1. Home health and personal care aides, Occupational Outlook Handbook (U.S. Bureau of Labor Statistics). Projected 2024 to 2034 employment growth and annual openings.
2. Ensuring Access to Medicaid Services final rule (CMS-2442-F) fact sheet (Centers for Medicare & Medicaid Services). The 80 percent compensation requirement for homemaker, home health aide, and personal care services.
3. CMS finalizes Medicaid access rule with 80/20 wage pass-through (LeadingAge). Applicability date, exclusions, and small provider flexibility.
4. Addus HomeCare to acquire Gentiva personal care operations (Addus HomeCare via SEC EDGAR). Example of a national consolidator buying personal care operations across seven states in 2024.

Reviewed October 2026

Questions owners ask

Straight answers, before you commit to anything.

What is my personal care agency worth?+

Usually a multiple of adjusted EBITDA, driven by staffed hours, caregiver retention, payer mix, and owner dependence. Smaller agencies trade at lower multiples than regional platforms because buyers take on more owner dependence.

How does the Medicaid 80/20 rule affect a sale?+

From July 9, 2030, states generally must ensure at least 80 percent of Medicaid payments for homemaker, home health aide, and personal care services go to direct care worker compensation. Buyers model how your Medicaid margins look under that rule, subject to how your state implements it.

Can I sell a franchised home care agency?+

Usually yes, but the franchise agreement typically requires franchisor approval of the buyer and a transfer fee, and may give the franchisor a right of first refusal.

Do buyers want private pay or Medicaid agencies?+

Both, for different reasons. Private pay brings margin; Medicaid brings volume. Buyers discount concentration in a single payer or referral source more than either payer type.

Related resources

Home care resources

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