5 Steps For Success When Starting An In-Home Health Agency

Starting an in-home health agency is a competitive but rewarding industry.

Due to the aging baby boomers and increased life expectancy, the number of senior citizens over the age of 65 is increasing every year. Recent statistics reflect the average United States life expectancy is 81 for women and 76-years-old for men. As a result of this data, a significant increase in medical and personal care needs is rising as well.

Over time it has become increasingly common and beneficial for patients to remain in the comfort of their residence while receiving in-home health care services. Studies have shown patients respond better and result in more of a positive outcome.

There may come a time while caring for elderly parents where you try to do everything possible, but it’s simply not enough. Sometimes after a hospitalization, a fall, a surgical procedure, or overall health decline, your mom or dad will frequently need assistance by a skilled therapist or nurse. This new twist in caring for our elderly population raises many questions for families. Many insurance companies, including Medicare, will pay for skilled services such as nursing care, medication management, diabetic teaching, IV therapy, home safety, or therapy when there is a specialized need.

Step 1: Creating A Business Plan

If you’re seeking to open in-home health agency, the following requirements must be met to receive therapy. You are under the supervision of a doctor and are receiving services under a plan of care established and reviewed regularly and signed by a doctor. Your doctor must certify that you need one or more of the prior services listed. Your insurance company or Medicare must approve the in-home health agency caring for you.

Also, your doctor must certify that you are homebound: meaning you have trouble leaving your residence without help such as a cane, walker, wheelchair, crutches, specialized transportation, or assistance from another person because of injury or illness.

This rapidly growing area of in-home health care offers excellent business opportunities for entrepreneurs in the healthcare industry.

If you are considering a business in the healthcare field, these steps will lead to your future successful in-home health agency!

This step applies when starting in any business venture. A business plan will cover several topics such as a company description, mission & vision, including a list of services to be provided.

A marketing plan will outline how people will learn about your business, which is imperative for obtaining referrals and building your patient census. You will need to define your ownership/ management organizational structure, operational, and financial plan.

Step 2: Register With The State 

You must certify your agency by completing your states’ in-home health care application for licensure. To receive payment from Medicare/ Medicaid, your agency must meet the established guidelines. You will also need to incorporate your business by obtaining an NPI (National Provider Identification Number).

These requirements will vary from state to state.

Step 3: Obtaining Medicare / Medicaid Certifications 

By obtaining these certifications, your agency will be able to provide in-home health care services such as nursing care, physical therapy, and other services and get paid through the Medicare/ Medicaid plans.

The process of becoming accredited can be lengthy, taking approximately up to one year to complete.

Step 4: Hiring Great Staff

Since your agency will be providing care to your patients, you want to ensure that staff members are a prime representation of what you desire your business to be. There are many ways to go about hiring staff members, such as website advertising (Indeed or Career Builders), personal referrals, and availability of social media.

This is a crucial step and may take some time before locating the type of employees you are searching to hire. Your goal when hiring staff is to find candidates that have the skill sets needed to provide the highest quality of care to your patients, and being bilingual is always a plus for the medical team.

As many patients request, their medical providers share their native language.

This is a crucial step and may take some time before locating the type of employees you are searching to hire. Your goal when hiring staff is to find candidates that have the skill sets needed to provide the highest quality of care to your patients, and being bilingual is always a plus for the medical team.

After completing the interviewing phase for a potential candidate, you must conduct a background check to avoid legal action if there is an issue related to patient care. Once hired, all employees play an essential role in developing a successful agency.

The office and field staff must be in close communication to discuss and address any patient care related details. Interdisciplinary team meetings are advantageous for discussing progress or concerns related to each patient. When working in the field, one must be self-motivated, have highly effective time management skills, and own the ability to work independently without direct supervision.

It’s recommended for field clinicians to communicate directly with patients when running late by informing them of their expected arrival or needing to reschedule the visit.

Step 5: Building Your Patient Census

Effective marketing strategies are the key to the process of obtaining patients. It’s imperative to have a marketing team or patient liaisons that are active and visible in the community by building personal relationships with healthcare providers.

Its a frequent occurrence for the marketing team to sponsor providers in services over breakfast or lunch, distributing company literature, and attending health fairs in the area.

In conclusion...

… the in-home health care industry will remain in demand and continue to be a lucrative and competitive business. In researching the details of this topic, it became very apparent there are thousands of in-home health care agencies available, however, delivering quality patient care must be the top priority and never be jeopardized at any time.

As previously stated, the benefits of home health care services include being cost-effective and increasing the patient’s comfort level by remaining in the comfort of their own home. Ensure the clinical staff develops a close 1:1 personal rapport with the patient and family members involved in their care.

I’m fortunate to have had the opportunity of working in the in-home healthcare field as a registered nurse for over 30 years.

I have worked in multiple clinical settings such as hospitals, skilled nursing facilities, medical offices, to name a few. For the past five years, I have been working as a field clinician, which I thoroughly enjoy as every day is a new adventure.

It’s a great experience to build personal relationships with patients & family members and assisting in the rehabilitation/healing process.

I want to invite other healthcare professionals to consider joining me in this exciting journey of being an in-home health care provider.

For any questions or additional information on how in-home health agencies set prices, please feel free to email me – Shannonsmgarr@aol.com.


  1. Mary Goround

    23rd Jan 2020 - 12:19 PM

    Thank you, I’ve just been looking for information about this topic for
    ages and yours is the best I have discovered till now.
    However, what concerning the bottom line? Are you positive about
    the supply?

    • Gento

      23rd Jan 2020 - 3:11 PM

      Hi Mary,

      Thanks for reaching out. The supply is there for the in-home health industry. It’s a popular aspect that over 10,000 “baby-boomers” turn 65-years old every day. Although opening an agency can be profitable, there are many regulations to follow like PDGM. Check out: https://gento.io/blog/pdgm-in-2020/ for more.

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