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Home-based care dealmaking is shifting toward selective purchases of clinically strong, compliant providers, according to industry experts cited by Home Health Care News. A Medicare enrollment moratorium may make established agencies more attractive, while the pace and scale of any market rebound remain uncertain.
Home-based care buyers are placing greater weight on regulatory compliance, care quality and financial records as the market moves away from the aggressive acquisitions of 2021, industry experts told Home Health Care News. The shift could favor established agencies as a Medicare enrollment moratorium limits the pool of new providers, though a broad return to peak deal volume has not been established.
Buyers remain interested in the sector, but are applying more scrutiny to prospective acquisitions, according to Cory Mertz, co-founder and managing partner of healthcare M&A adviser Mertz Taggart. Agencies with accurate accounting and strong operating practices can still command premium values, he said, while average or weaker companies that might have sold in the past are finding fewer buyers. Jason Growe of home health and hospice provider LiveWell Partners also described current deals as stronger in profitability and care quality than those seen during the earlier boom.
Financing conditions have changed since 2021, when low interest rates and readily available debt supported more aggressive acquisitions, said Les Levinson, a partner at law firm Robinson+Cole. Buyers now need to contribute more equity, increasing the capital required for each transaction and encouraging more selective purchasing. Levinson said macroeconomic conditions weighed on dealmaking in the first and second fiscal quarters of 2026, citing interest rates and global disruptions.
In August, the Braff Group reported that home-based care dealmaking was gaining momentum and said activity could increase through 2027. The report’s outlook is not confirmation that transactions have already returned to earlier levels. Industry sources also point to investor interest in lower-cost care delivered at home. In July, LiveWell acquired Michigan Community VNA Home Health and Hospice, marking its third deal in Michigan, Growe said.
Compliance and Enrollment Limits Affect Deals
Levinson said compliance can preserve a company’s value, increase it, or cause a transaction to stall or collapse. Buyers review providers’ practices during due diligence, and uncertainty about those practices can raise concerns about a transaction.
Levinson said limits on new Medicare enrollments could make established providers that meet applicable standards more attractive to buyers. The source material does not quantify the moratorium’s effect on sale prices or deal volume.
Growe cited the potential for lower care costs and patients’ preference to receive care at home as factors in investor interest in home-based care. Financing costs, regulation and company-level quality also affect which transactions proceed.
From 2021 Boom to Selective Buying
During the 2021 acquisition surge, inexpensive capital let private equity firms and other buyers finance transactions with more debt, Levinson said. Higher financing costs have since changed those calculations: buyers must put more equity into deals and are weighing acquisitions more carefully.
The market picture in 2026 is mixed. Levinson described weaker-than-expected activity in the first two fiscal quarters, while the Braff Group’s August report pointed to renewed momentum that could carry into 2027. Mertz said a proposed CMS payment update also provides some near-term visibility: in July, CMS proposed a 2.4% aggregate increase in home health payments. The proposal is not a finalized payment rule.
Buyers are also showing increased demand for Medicaid-reimbursed personal care and private duty nursing, Mertz said. Those programs are administered by states, adding another area of interest alongside Medicare-funded home health.
“The regulatory compliance feature has always been the most important.”
— Les Levinson, partner at Robinson+Cole
Deal Volume and Rule Still Unsettled
The available reporting does not establish how many transactions will close, whether deal volume will reach the levels seen about five years ago, or how much the enrollment moratorium will affect valuations. The Braff Group’s projection of stronger activity through 2027 is an outlook, not a reported outcome.
CMS’s 2.4% aggregate home health payment increase is proposed, and the final 2027 payment rule was not yet established in the source material. The duration and market effects of the enrollment moratorium, as well as the scale of future Medicaid and private duty nursing transactions, also remain unclear.
Buyers Track Rules and Pipelines
Buyers and sellers will be watching CMS’s next steps on the proposed home health payment rule and how the enrollment moratorium affects eligible agencies. Mertz said the proposed payment update gives the market more certainty for the next 12 months, until another proposed rule is issued.
Growe forecast that the industry’s deal pipeline could accelerate over the next two to three years. That remains a prediction; upcoming transaction activity, financing conditions and providers’ compliance records will show whether the forecast is borne out.
Key Questions
What is changing in home-based care acquisitions?
Industry experts say buyers are being more selective and focusing on compliance, care quality and accurate financial records.
How could the Medicare enrollment moratorium affect deals?
Levinson said limits on new enrollments may make established agencies that meet the standards more attractive. The reporting does not quantify the effect on prices or transaction volume.
Has home-based care dealmaking returned to its 2021 peak?
No such return is confirmed in the source material. Experts described weaker activity in early 2026 and possible momentum ahead, while noting that the market has not reached the earlier dealmaking frenzy.
Is the proposed 2.4% home health payment increase final?
No. CMS proposed an aggregate 2.4% increase in July 2026; the final payment rule was not established in the reporting.
Source: rss
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