Home-based care M&A activity rebounded sharply in Q2 2026. After a Q1 that was tactically slower than the back half of 2025 — slowed by interest-rate uncertainty and a wait-and-see pause from several large platforms — capital deployment, deal closings, and buyer engagement all stepped up materially in April, May, and June.
Below is Hendon Partners’ breakdown of the quarter: transaction volume, valuation multiples by sub-sector, the most active buyers, the structural themes shaping deals, and what sellers should take from it.
| Metric | Q2 2026 | vs. Q1 2026 | vs. Q2 2025 |
|---|---|---|---|
| Total tracked transactions | 95–110 | +18% | +12% |
| Disclosed deal value | $4.2B+ | +35% | +22% |
| Mega-deals ($500M+) | 4 | +3 | +1 |
| PE-backed buyer share | ~68% | flat | +4 pts |
| Strategic buyer share | ~24% | -3 pts | -2 pts |
| Median process timeline | 7.1 months | -0.4 mo | -0.7 mo |
Source: Hendon Partners transaction tracking, public announcements, and proprietary deal data. Figures include personal care, home health, hospice, IDD, ABA/autism therapy, behavioral health, pediatric home health, and private duty nursing.
Q2 2026 multiples held in line with Q1 with mild firming at the upper end, particularly for hospice and pediatric platforms.
Buyer appetite remains strongest for agencies with diversified payer mix (private pay or MLTSS-balanced), proven caregiver retention, and clean compliance histories. Heavily Medicaid-concentrated agencies in non-MLTSS states traded at the lower end of these ranges.
The continued Medicare Advantage migration and PDGM mechanics kept buyers focused on agencies with strong STAR ratings (4.0+), low LUPA rates, and demonstrated ability to manage MA at margin.
Hospice continued to be the highest-multiple sub-sector. The IPO and re-IPO whisper market for hospice consolidators kept platform buyers aggressive. Cap exposure, length-of-stay distribution, and live-discharge rates remained the key diligence levers.
State-specific Medicaid waiver dynamics drove dispersion. Texas, Florida, and Pennsylvania pediatric platforms drew the most competitive bids.
State rate environments and HCBS waiver structures were the dominant valuation variables.
ABA multiples have normalized from their 2022–2023 peak. Payer concentration with single commercial plans and clinician productivity benchmarks were Q2’s dominant scrutiny areas.
Outpatient mental health and substance use disorder treatment drew significant PE interest in Q2, with several new platforms launched.
A wave of independent sponsors and family offices also closed mid-market deals in the $5M–$25M EV range, particularly in personal care.
In Q2, more than 70% of mid-market home care transactions advised by Hendon Partners and tracked across the broader market involved some level of equity rollover. PE platforms continue to require 10–35% rollover from selling shareholders, both for alignment and to bridge valuation gaps.
Q2 saw an uptick in late-stage retrades tied to working capital peg disputes — particularly for Medicare home health agencies with elongated A/R cycles. Sellers who modeled their peg before LOI execution closed at the negotiated price; sellers who deferred the analysis routinely surrendered $200K–$1M+ at close.
Buyer underwriting of personal care agencies serving HCBS Medicaid waiver populations now routinely models the 80/20 compliance pathway. Agencies with credible compliance plans traded at standard multiples; agencies without took 0.5x–1.5x discounts.
PE-backed buyers represented ~68% of Q2 deal flow, modestly higher than Q2 2025. Strategic acquirers were more disciplined on price — closing tuck-ins where synergies were obvious and passing where they were not.
For deals with EBITDA above $1.5M, third-party Quality of Earnings is now standard practice. Sellers who came to market with sell-side QoE in hand materially compressed timelines and avoided late-stage retrades.
While many Q2 deals remained confidential, several disclosed transactions illustrate the pricing and structural themes of the quarter. (Hendon Partners curates a more detailed deal log for clients on request.)
The market conditions you would want at exit are present today: abundant buyer capital, stable-to-firming multiples, structured competitive processes clearing at the upper end of historical ranges, and lender appetite restored across most sub-sectors. The window favors prepared sellers.
Use the runway. Q2’s biggest valuation gaps were not between strong and weak markets — they were between prepared and unprepared sellers. Sell-side QoE, working capital modeling, compliance pre-audit, EBITDA add-back documentation, and caregiver retention metrics are what separated the high-multiple closes from the retrade casualties.
Q2 reinforced the cost of going direct. Agencies that responded to a single buyer inbound closed 20–40% below comparable agencies that ran competitive processes. Even one additional credible bidder fundamentally changes the negotiation.
The pipeline of marketed transactions entering Q3 is the largest Hendon Partners has tracked since late 2021. Expect continued multiple stability, a robust deal calendar through year-end, and a meaningful uptick in mega-deals as platforms approach fund-cycle exit windows.
For sellers contemplating a 2026 or 2027 transaction, the next two quarters will likely be the most favorable execution window of this cycle.
Schedule a confidential market briefing with Hendon Partners →
Hendon Partners is a sell-side only home care M&A advisory firm. Our market reports synthesize disclosed transaction data, proprietary deal flow, and direct conversation with active buyers across personal care, home health, hospice, IDD, behavioral health, ABA, and pediatric home health.
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