The Growth of Home Care In America

Stephen Tweed | August 29, 2024 | News and Views
I love doing research. I love conducting focus groups, interviews, and industry surveys. I love analyzing the data to develop information, knowledge, and wisdom about our industry. What about you? Are you curious about the industry we work in and that we devote our lives and our passion to? One of the most frequently asked…

I love doing research.

I love conducting focus groups, interviews, and industry surveys.

I love analyzing the data to develop information, knowledge, and wisdom about our industry.

What about you? Are you curious about the industry we work in and that we devote our lives and our passion to?

One of the most frequently asked questions about home care is,

“How Many Home Care Companies are there in the US?”

The short answer is … we don’t know for sure. There are still 20 states that do not have a requirement that Home Care companies be licensed. Only 30 states require a license.

However, a longer answer is that we have gathered as much information as we can and have made some educated guesses about how many companies are serving this industry. Looking at available state licensure lists, and our review of Home Care franchise companies, we believe there are 27,000 companies providing Home Care in our country.

Just last week I received the 2024 list of Home Care Franchise Companies, with the updated number of units in each company. Since 2013, Leading Home Care has retained a researcher to gather the latest information on all of the companies in Home Care that offer franchises.

We learned that in 2024:

  • There are 58 companies that offer Home Care Franchises
  • The top 21 companies have 100 or more locations.
  • As of August 2024, there are 8,540 franchise units
  • There are 12 companies that once offered franchises but are no longer franchising, although they are still in the Home Care business
  • There 9 companies that once offered franchises but are not out of business.

The Top Ten Franchisors have 66.7% of all Units

You have probably heard of The Pareto Principle, or more specifically the Pareto Principle of Maldistribution. It says that 80% of anything are the result of 20% of the participants.

You’ve heard people say …

  • 80% of sales are made by 20% of sales people
  • 80% of market share is owned by 20% of companies in the market
  • 80% of call offs and no-shows are done by 20% of caregivers

Well, in Home Care Franchising, it’s not quite like that. In our case …

  • 66.7% of Home Care Franchises are affiliated with 17% of the franchise companies.
  • The top ten companies have a total of 5,699 franchise units.

We also learned from our research that Home Care Franchises are growing rapidly. The total number of franchise units grew from 7,469 in April 2023 to 8,540 just 15 months later. What we don’t know is how many new Independent Home Care companies or Affiliated Home Care companies were added during that same time. We’ll keep working on that.

Stephen Tweed
Stephen Tweed is among the top Thought Leaders in Home Care today. As an industry researcher, author, and executive coach, he has worked with owners and CEOs of companies in the top 5% of Home Care and is a frequent speaker at Home Care association conferences and corporate meetings across the US and Canada.

Related Posts

The Future of Home Care

October 23, 2025
I've been thinking about the Future of Home Care. I was in Dallas, TX on Monday and Tuesday this week at the Home Care Association of America National Leadership Conference. What a major milestone. There were 850 Home Care providers and suppliers -- the largest attendance every. I remember pretty clearly going back to 2004…

Artificial Intelligence in Home Care

October 9, 2025
I've been thinking about the impact of AI on Home Care. Three things happened this week that have totally shifted my awareness and thinking about Artificial Intelligence. First, I've been reading a new book that was recommended to me called "Reshuffle" by Sangeet Paul Choudary. He's a senior fellow at UC Berkley, and a strategic advisor…

The 2026 Future of Home Care Study.

October 7, 2025
For the past month, I've been working with my friends at AxisCare to refine the survey for the 2026 Future of Home Care Study. This year, we have added some new questions based on last year's data, and we have added a whole new section on AI. This year's study has three major sections; Industry…