Texas Home Care Market at a Glance
4.2 million (65+)
Senior Population
15.9% (2020-2030)
Projected Growth
2.5x - 4.5x
Typical Multiples
$8.2 Billion
Market Size
Key Market Facts
Fastest-growing senior population in the US with 1,200+ people moving to Texas daily
No state income tax makes Texas attractive for both buyers and sellers structuring deals
Four major metros (Houston, Dallas, San Antonio, Austin) each offer distinct buyer pools
Strong private pay market in affluent suburbs like The Woodlands, Plano, and Westlake
Hispanic population (40%+) creates demand for bilingual and culturally-competent care
Texas has over 4,000 licensed home care agencies - highly fragmented market ripe for consolidation
Market Opportunities
Population growth of 470,000+ annually creates organic demand expansion
Large Hispanic population values family-centered care - agencies with Spanish-speaking staff command premiums
Multiple PE-backed platforms actively acquiring in Texas: Help at Home, BrightSpring, Addus HomeCare
Austin and Dallas-Fort Worth metros seeing highest buyer interest due to demographic trends
Veterans Administration contracts available through VA Community Care Network
Medicaid waiver programs (CLASS, DBMD, HCS) offer diversification beyond traditional home care
Market Challenges
Caregiver wages rising 15-20% in major metros due to competition from retail and hospitality
Medicaid reimbursement rates 10-15% below national average; private pay essential for healthy margins
Geographic spread between metros (Houston to Dallas is 240 miles) complicates multi-location operations
Hurricane and flood exposure in Houston/Gulf Coast requires business continuity planning
High competition in Houston market - over 800 licensed agencies in Harris County alone
EVV (Electronic Visit Verification) compliance required for all Medicaid-funded services
Texas Regulatory Environment
Licensed by Texas Health and Human Services Commission (HHSC) - Home and Community Support Services Agencies (HCSSA)
STAR+PLUS Medicaid managed care program covers 1.5M+ members through MCOs like Molina, UnitedHealthcare, and Superior
License categories: Licensed Only, Licensed and Certified (Medicare), or Licensed and Certified (Medicaid)
Criminal background checks required through DPS for all employees with client contact
Annual license renewal with $375 fee; surveys conducted every 3 years or upon complaint
No Certificate of Need (CON) requirements - relatively easy market entry compared to other states
Data Sources
Market Size: Estimated from IBIS World Home Care Providers Industry Report and state-level Medicare/Medicaid expenditure data.
Valuation Multiples: Derived from M&A transaction databases and industry broker reports for home care and home health agencies.
Growth Projections: Based on 65+ population projections from the U.S. Census Bureau (2020-2030).
Senior Population: U.S. Census Bureau American Community Survey estimates.