Home care enables older adults and people with disabilities—disproportionately low-income and people of color—to remain in their communities while lowering costs relative to nursing homes (p.2). The market totals roughly $140B across Home Health Care Services ($92.5B) and Services for the Elderly and Persons with Disabilities ($47.9B); total long-term care spend was ~$246B in 2015 (pp.5–6). Demand is rising with aging demographics and higher multimorbidity, while Medicaid and managed care models shift spend toward home- and community-based services (pp.7–8). Constraints include extreme fragmentation, sticky/low reimbursement, thin margins (4–7%), cash-flow delays from MCOs, and looming workforce shortages tied to low wages and high turnover despite FLSA protections (pp.9–12,14–16). Inherent impact emerges when businesses that keep clients healthier can share in avoided costs, but evidence/ROI systems remain nascent (p.2)
Some Identified Companies
- ClearCare – software for home-care agencies improving operations/outcomes (p.21)
- Honor – tech-enabled home-care service and back-office network for agencies (pp.21–22).
- Hometeam – in-home care marketing to Medicaid MCOs for predictable acquisition (p.21).
Notable Investors
- Battery Ventures – investor in software infrastructure for agencies (p.21).
- Andreessen Horowitz – investor in tech-enabled home-care models (p.21).
- Kaiser Permanente Ventures – strategic healthcare investor in home-care services (p.21).