# The 2026 National Home Health Study 2026 National Home Health Study | Astrelis State of the Industry Built on 2024 federal data and current 2026 policy. The headline numbers are hiding the industry. Page: https://astrelis.co/studies/home-health/2026 This twin: https://astrelis.co/studies/home-health/2026.md Edition: 2026 Published: 2026-07-18 Author: Matt Borchardt, Founder, Astrelis Release: 2321a4fc37a7 (2026-10-22) ## Data vintage This 2026 edition stands on 2024 federal reporting cycle and CY2026 policy. - Published July 2026 ยท Version 1.0 - Data: 2024 federal reporting cycle and CY2026 policy - Sources: MedPAC, CMS, KFF, BLS, peer-reviewed research - Analytic universe: 12,234 (Home Health) ## Headline findings, as printed 1. **The growth that isn't** America outside California has fewer home health agencies than it did in 2019. 2. **The margin that sets your rates is not the margin you live** Freestanding agencies earned a 21.2 percent margin on fee-for-service Medicare in 2024. Their all-payer margin was 5.0 percent. 3. **The vanishing visit** Home health delivered 65.4 million in-person visits in 2024. In 2019 it delivered 99.7 million. 4. **The Medicare Advantage gap** Medicare Advantage now covers 55 percent of eligible beneficiaries, and it buys less home health per patient than traditional Medicare does. 5. **The discharge that never lands** Home health is the most common formal post-acute destination in traditional Medicare, and the handoff to it fails four times out of ten. 6. **The windshield tax** One in ten rural ZIP areas has no home health agency at all. In the most remote areas, it is one in three. 7. **The workforce math does not close** The labor pool must fill roughly 765,800 aide openings a year, most of them replacements, at a median wage of $34,900. ## The seven numbers from this study worth carrying into your next board meeting - 9,320: Medicare home health agencies outside California in 2024, down from 9,823 in 2019. National growth is a California story, and CMS froze new enrollment nationwide in May 2026. - 21.2 vs 5.0: The 2024 fee-for-service Medicare margin versus the all-payer margin for freestanding agencies. Policy prices the first number. You live the second. - 8.4: In-person visits per 30-day period in 2024, down from 10.2 in 2019. Total visits fell from 99.7 million to 65.4 million. - 11 percent: How many fewer visits Medicare Advantage patients receive than fee-for-service patients, while MA covers 55 percent of eligible beneficiaries and 90 percent face prior authorization for home health. - 59 percent: The share of hospital referrals to home health that are actually fulfilled, down from 66 percent in 2016. Care starting 8 to 14 days late carries roughly four times the rehospitalization odds. - 10.3 percent: The share of rural ZIP areas with no home health agency at all. In the most remote frontier areas, 33.1 percent. - $34,900: Median pay for the workforce that must fill 765,800 openings a year through 2034, most of them replacements, with turnover running from 21 percent to near 75 percent depending on the segment. ## Sources Every figure is attributed in the text to its originating source; the full source list is the study's appendix on the page. Print layout (PDF): https://astrelis.co/research/2026-national-home-health-industry-study-astrelis.pdf. Also in the series: https://astrelis.co/studies ## Cite Astrelis, "The 2026 National Home Health Study" (2026 edition), https://astrelis.co/studies/home-health/2026, published 2026-07-18; release 2321a4fc37a7 (2026-10-22). Figures are as published by the named sources and were not audited by Astrelis. Astrelis is not a CPA firm and performs no audit, review or attestation of any facility.