Home Health vs. Home Care: Which Business Should You Start?
Home health and non-medical home care are very different businesses. Compare services, payers, licensing, staffing, and startup complexity before you invest.
If you’re exploring the in-home care industry, you’ll quickly run into two terms that sound almost identical: home health and home care. They serve overlapping clients, but they are very different businesses to own and operate. Choosing the right one is one of the most important decisions you’ll make.
The short answer
- Home health = skilled medical care at home, ordered by a physician and usually billed to Medicare or other insurance.
- Home care = non-medical help with daily living, usually paid privately, through long-term care insurance, or through certain VA and Medicaid programs.
Side-by-side comparison
| Non-medical home care | Home health (skilled) | |
|---|---|---|
| Services | Personal care, companionship, meal prep, mobility help, respite, 24-hour and live-in care, medication reminders | Skilled nursing, physical/occupational/speech therapy, wound care, injections, medical social work |
| Who orders it | The client or family | A physician, under a plan of care |
| Primary payers | Private pay, long-term care insurance, VA programs, some Medicaid waivers | Medicare, Medicaid, commercial insurance |
| Staff | Caregivers, home health aides, office team; sometimes an RN for assessments | RNs, LPNs, therapists, aides, clinical managers |
| Licensing & certification | State home care license or registration (varies by state) | State license plus Medicare certification and accreditation |
| Compliance burden | Moderate | High, with extensive clinical documentation and federal regulation |
| Owner background | Varies by company (All Hours awards franchises only to licensed healthcare providers) | Typically requires clinical leadership |
| Time to launch | Usually months | Often much longer, since Medicare certification can be lengthy |
Why many first-time owners choose non-medical home care
- Lower barrier to entry. You don’t need Medicare certification or accreditation to open.
- Simpler revenue model. Private-pay clients and long-term care insurance avoid much of the complexity of Medicare reimbursement.
- Faster path to opening. Licensing timelines vary by state but are generally shorter than Medicare-certified home health.
- Longer client relationships. Clients often receive care for months or years, and needs typically grow over time, including overnight, 24-hour, and live-in care.
- Meaningful, relationship-driven work. You get to know clients and families personally.
When home health might make sense
Skilled home health can be a strong business for experienced clinical leaders and operators who are comfortable with Medicare billing, clinical compliance, and accreditation. Some mature non-medical agencies also expand into skilled services later, or partner with home health agencies for referrals.
How the two work together
Home health and home care are natural referral partners. A client discharged from the hospital may receive a few weeks of skilled home health visits, then continue to need help with bathing, meals, and safety long after skilled care ends. Non-medical agencies that build strong relationships with local home health providers, hospitals, and rehab facilities can become the trusted next step for those families.
The All Hours Home Healthcare model
All Hours Home Healthcare franchises provide both medical and non-medical home care, including skilled medical care at home, personal care, companion care, respite, dementia and Alzheimer’s care, transitional care, and our specialty, 24-hour and live-in care. Every All Hours franchise is awarded exclusively to a licensed healthcare provider, so families get one trusted provider across the full spectrum of care, led by someone referral partners trust. Learn why we award franchises only to licensed healthcare providers.
Learn why entrepreneurs choose All Hours, explore the investment, or request franchise information.