M&A Intelligence
Practitioner-authored articles, valuation benchmarks, and deal intelligence for home care owners and acquirers.
Newsletter
Stay ahead of the market
Receive new articles, EBITDA benchmark updates, and deal alerts directly in your inbox. No spam — unsubscribe anytime.
Join 1,200+ home care executives and advisors.
North Carolina is a CON state with strong demographic growth, dense Charlotte and Triangle buyer competition, and one of the most active home care M&A markets in the Southeast.
Adult day health centers and adult day programs are an undercovered M&A niche with strong demographic tailwinds and emerging buyer interest. Here is what owners should know about valuations and exit options in 2026.
Georgia is a CON state with restricted home health licensure, dense Atlanta-area buyer competition, and growing demographic demand — making it one of the Southeast's premier home care M&A markets.
Palliative care is rapidly emerging as a distinct M&A category — different from hospice in payer mix, clinical model, and valuation. Here is what palliative care agency owners should know about selling in 2026.
New Jersey's CON-protected home health market and dense Medicaid managed care landscape make it one of the highest-multiple home care M&A markets in the country.
Home infusion and specialty infusion pharmacy M&A activity has accelerated meaningfully in 2026. Here is what owners of home infusion, ambulatory infusion, and specialty pharmacy platforms should know about valuations, active buyers, and deal mechanics.
Ohio is one of the most active Midwest home care M&A markets, with concentrated buyer interest across PASSPORT-funded personal care, Medicare home health, and hospice. Here is what Ohio owners should know.
Colorado is a fast-growing Mountain West home care market with attractive demographics and increasingly competitive buyer interest. Here is what CO owners should know about selling in 2026.
The CMS Change of Ownership (CHOW) process determines how Medicare provider numbers transfer in home health and hospice sales. Here is what sellers must know about timing, structure, and successor liability.
Illinois is one of the largest Midwest home care markets, with a complex Medicaid environment, active Chicago-area buyer interest, and unique regulatory dynamics. Here is what IL owners should know about selling in 2026.
Massachusetts is a high-acuity, managed-care-dominated home care market with significant ACO and MassHealth dynamics. Here is what MA home care, home health, and hospice owners should know about selling in 2026.
The Confidential Information Memorandum is the core marketing document in a home care M&A process. Here is what goes in it, who sees it, and how it shapes valuation.
Pennsylvania is one of the most active mid-Atlantic home care M&A markets, with a complex licensing structure, large MLTSS population, and deep buyer interest. Here is what PA owners should know about selling in 2026.
Most home care deals do not die at the negotiation table — they die in due diligence over preventable issues. Use this tactical checklist to surface and remediate every common deal killer 6–12 months before launch.
EBITDA add-backs are how home care owners convert reported earnings into the normalized EBITDA buyers value. Here is the complete list of accepted add-backs with documentation requirements.
Addiction treatment and substance use disorder M&A activity has accelerated sharply in 2026. Here is what owners of MAT clinics, residential, IOP, and PHP programs should know about valuations, active buyers, and deal mechanics.
Seller financing remains a meaningful component of mid-market home care M&A. Here is how seller notes work, when they appear, and how to structure them to protect your interests.
Indemnification provisions determine your post-close exposure. Survival periods, baskets, caps, and carve-outs all materially affect what you actually keep from the sale. Here is the seller's framework.
New York is one of the largest, most regulated, and most strategically valuable home care markets in the country. Here is what NY home care, home health, and hospice owners should know about selling in 2026.
Knowing which PE firm to approach — and which to avoid — is one of the highest-leverage decisions a home care seller will make. Here are detailed profiles of the most active private equity buyers in 2026.
The working capital peg is one of the most contested adjustments in home care M&A — and one of the most commonly misunderstood by first-time sellers. Here is how it works and how to negotiate it.
Whether your home care agency is sold as assets or as stock affects taxes, licensure transfer, contract assignment, and successor liability. Here is the seller's framework.
Home-based care M&A activity rebounded sharply in Q2 2026. Here is Hendon Partners' breakdown of deal volume, valuation multiples by sub-sector, the most active buyers, and what sellers should take from the quarter.
Escrow and holdback structures determine how much of your purchase price is delayed at close. Here is how each works in 2026 home care deals — and how to negotiate them down.
Roughly one in three signed LOIs in home care M&A never reaches close. Here are the 10 most common deal killers — and the specific seller-side actions that prevent each one.
Applied Behavior Analysis (ABA) and autism services have been one of the most active behavioral health M&A segments of the past decade. Here is how ABA agencies are valued in 2026, how multiples are evolving after the post-2022 reset, and what buyers actually look for.
How buyers finance home care agency acquisitions has direct implications for sellers — affecting deal structure, certainty of close, and the share of consideration paid in cash at close. Here is a practical guide to the financing options shaping home care M&A in 2026.
Selling your home care agency is the most important financial decision of your career — and you only get one chance to do it right. Here is how specialized M&A advisory transforms first-time-seller outcomes.
Medicare Advantage now accounts for more than half of all Medicare beneficiaries — and the rate differential between MA and traditional Medicare is one of the most consequential variables in home health agency valuation in 2026. Here is how buyers are modeling MA exposure.
Representation and warranty insurance has reshaped home care M&A by reducing escrow requirements and limiting seller indemnification exposure. Here is how R&W works and when sellers benefit.
The IOI is the first formal valuation indication from buyers in your home care sale process. Here is how to read IOIs, compare them, and convert them into LOIs that maximize value.
The Letter of Intent (LOI) is the most consequential negotiated document in any home care sale before the purchase agreement. Here is what to negotiate — and what to avoid conceding.
Whether your agency is acquired as a new platform or a tuck-in to an existing one is one of the largest valuation variables in home care M&A. Here is how each buyer type values you — and how to position for the higher one.
Michigan combines MI Health Link dual-eligible managed care, MI Choice Waiver personal care, and concentrated Detroit and Grand Rapids buyer interest into one of the Midwest's most active home care M&A markets.
Certificate of Need restrictions in approximately 15 states fundamentally change home health and hospice M&A dynamics. Here is what sellers and buyers need to understand about CON state valuation, transaction structure, and the regulatory mechanics that drive premium multiples.
The advisor you hire to sell your home care agency materially affects the valuation, deal structure, and certainty of close you achieve. Here is how to think about the choice between a business broker, a healthcare M&A advisor, and an investment bank.
The agencies that achieve premium valuations are almost always the ones that began preparing 12 months or more before going to market. Here is the month-by-month checklist for getting your home care, home health, or hospice agency sale-ready.
California is one of the most regulated home care markets in the country, with HCO licensing, IHSS dynamics, strict labor law, and distinct M&A characteristics. Here is what California home care, home health, and hospice owners should understand about selling in 2026.
Texas is one of the largest and most active home care M&A markets in the country, with HCSSA-licensed agencies operating across a sprawling, demographically favorable state. Here is what Texas home care, home health, and hospice owners should know about selling in 2026.
Florida is one of the most active home care M&A markets in the country, with strong demographics, a deep buyer pool, and distinct licensing and regulatory mechanics. Here is what Florida home care, home health, and hospice owners should know about selling in 2026.
Private equity continues to drive the majority of home-based care M&A activity in 2026. Here is a working guide to the most active PE platforms and sponsors acquiring home care, home health, hospice, pediatric, and behavioral health agencies — and what each looks for.
Pediatric home health and pediatric private duty nursing agencies are commanding premium multiples in 2026 — often 6× to 9× EBITDA — driven by acute clinical complexity, scarcity of qualified nurses, and intense PE platform interest. Here is how buyers actually value pediatric agencies.
The CMS Medicaid Access Rule — commonly known as the 80/20 rule — requires that 80% of Medicaid HCBS personal care, home health, and homemaker payments go directly to caregiver compensation. For Medicaid-dependent home care agencies, the rule is one of the most consequential valuation variables of the next decade.
Home-based care M&A activity in Q1 2026 reflected stabilized buyer interest, modest sequential improvement in deal volume, and continued segmentation between premium-quality assets attracting competitive bids and average assets pricing at lower multiples. Here is our quarterly read of the market.
The home care M&A market in 2026 is characterized by selective but active buyer interest, stabilized multiples, and growing PE focus on clinical complexity and specialty care. Here is our perspective on current market conditions and what sellers should understand heading into a sale.
The shift to Medicaid managed long-term services and supports (MLTSS) is transforming home care agency economics — and therefore valuations. In some states, MLTSS creates significant value. In others, it compresses margins. Here is how to evaluate your position.
Healthcare staffing companies — particularly those serving home care, skilled nursing, and hospitals — are active M&A targets in 2026. But the valuation framework is different from traditional home care agencies, and the due diligence focus areas are distinct. Here is what you need to know.
A third-party sale is not the only way to exit a home care agency. Family succession, management buyouts, ESOPs, gifting programs, and phased exits are all viable alternatives depending on your goals. Here is how each option works and who it is right for.
When a private equity firm acquires your home care agency, they often ask you to roll a portion of your proceeds into equity in the combined entity. This can be highly lucrative — or it can be a distraction from a clean exit. Here is how to evaluate the decision.
Private equity now represents 62% of buyer-side home care M&A transactions. Understanding how PE firms evaluate targets, what multiples they pay, and how they structure deals is essential for any owner considering a sale in 2026.
The CIM is the most important document in any home care agency sale. It is the comprehensive business profile used to attract buyers and set the financial narrative. Here is what goes into a great CIM — and why the quality of your CIM directly affects your sale price.
After advising on 150+ home care M&A transactions, we've identified the same avoidable mistakes that cost owners millions of dollars at closing. Learn what they are — and how to avoid every one of them.
Confidentiality breaches during a home care agency sale can devastate the business you're trying to sell. Employees leave, referral sources redirect, and buyers lose confidence. Here is how to structure your sale process to protect confidentiality at every stage.
What EBITDA multiples are home care, home health, and hospice businesses trading at in 2026? Benchmark data from 150+ closed transactions, broken down by service line, deal size, and geography.
The single most common question home care agency owners ask before a sale. The answer depends on three factors: market timing, your personal situation, and the readiness of your business. Here is how to think through all three.
Private equity firms are consolidating home care agencies across the country through a 'platform and add-on' roll-up strategy. Understanding how this works — and why it creates compelling acquisition opportunities for smaller agencies — could be the most important market knowledge a seller has.
Home care agency valuations range from 2× to 10× EBITDA depending on service line, payer mix, and operational quality. This guide explains exactly how buyers value your business — and what moves your multiple higher.
Most home care agency owners don't know how their business is valued until they're already in a sale process — which is far too late to do anything about it. Here is the exact methodology buyers use to value your agency, with worked examples.
Most home care owners who sell without an advisor leave 24–40% of their sale price on the table. This complete guide walks you through every step of a professional, competitive M&A process — from valuation to funded close.
Medicare-certified home health agencies trade at a significant premium — but the sale process is more complex than most sellers anticipate. Licensing transfer, Medicare enrollment, and CHAP/JCAHO accreditation all create unique due diligence challenges. Here is what you need to know.
EBITDA add-backs are the most negotiated financial items in every home care agency sale. Adding $300,000 in legitimate add-backs at a 5× multiple adds $1.5M to your sales price. Here's which add-backs hold up to scrutiny — and which ones will get you in trouble.
Payer mix is the most scrutinized variable in home care agency valuation. A Medicare-certified home health agency and a Medicaid-only personal care agency with identical revenue can have dramatically different valuations. Here's why — and what you can do about it.
Non-compete agreements are a required part of every home care agency sale — but their scope, geography, and duration vary enormously. Understanding what is market-standard helps you negotiate terms you can live with for years after close.
Every home care agency sale follows the same fundamental 8-step process. Understanding each step — what happens, what you need to do, and what can go wrong — is the foundation of a successful exit.
Most resources focus on how to sell your home care agency. Almost nothing prepares you for what comes after. Here's what to expect in the 12–24 months following your close — financially, operationally, and personally.
The working capital adjustment is often the most disputed element of a home care agency sale — and one of the least understood by sellers going into the process. Here's exactly how it works and how to protect yourself.
Behavioral health is experiencing the most active M&A market in its history. Mental health practices, SUD treatment programs, and outpatient behavioral services are attracting intense PE interest. Here's what your business is worth and who is buying.
Private duty nursing agencies serving medically complex patients are among the highest-value home care businesses per dollar of revenue. Here's what drives PDN valuations in 2026 and what buyers look for in this specialized market.
Finding the right buyer for your home care agency is not about listing on BizBuySell or waiting for a cold call. The buyers who pay the highest prices are rarely the ones who find you first. Here's how the process actually works.
The tax structure of your home care sale can reduce your net proceeds by 10–20% — or protect them. The strategies that matter most must be implemented 12–24 months before close. Here's what every owner needs to know.
An earnout looks like more money. It often isn't. Understanding when earnouts protect sellers — and when they are a trap that transfers risk without reward — is essential before signing any home care acquisition agreement.
Due diligence is where deals die — or get repriced by millions. This complete checklist covers every document, record, and disclosure a home care agency seller needs to prepare before going to market.
Caregiver turnover is the #1 operational risk buyers underwrite in every home care acquisition. High turnover can reduce your multiple by 1–2× EBITDA. Here's exactly how buyers assess your workforce and what you can do about it before going to market.
Intellectual and developmental disability (IDD) agencies are among the most actively acquired healthcare businesses in the country right now. Here's what your IDD agency is worth, who is buying, and how to run a process that captures maximum value.
Private equity firms have acquired hundreds of home care agencies in the past decade. Here's exactly what they screen for, what disqualifies an agency immediately, and how to position your business to attract the most competitive PE offers.
The Quality of Earnings (QoE) report is the buyer's most powerful tool for repricing your home care agency after you sign the LOI. Understanding how QoE works — and preparing for it — can protect millions in proceeds.
The Letter of Intent is the most important document you will sign in your home care agency sale — and the most negotiated. Most sellers don't realize how many critical terms are set at the LOI stage. Here's what every clause means and how to protect yourself.
A majority recapitalization lets you sell 60–80% of your home care agency now — taking a large liquidity event — while retaining equity to capture the upside of the next phase of growth. Here's how it works and when it makes sense.
From first conversation to funded close, selling a home care agency typically takes 6 to 12 months. Here's exactly what happens at each stage, what causes delays, and how to move faster without leaving money on the table.
Should you sell your home care agency to a strategic acquirer or a private equity-backed platform? The answer depends on price, culture, your post-close role, and what you want your legacy to look like. Here's the complete comparison.
Hospice agencies are commanding the highest EBITDA multiples in all of home-based care — 5× to 9× or more for quality operators. Here's exactly how buyers value hospice businesses in 2026 and what separates an average outcome from a premium one.
No articles in this category yet.
