The traditional in-home care model—focused primarily on filling hourly caregiving shifts—is no longer enough. To thrive in today’s challenging environment, agencies must expand their vision beyond just providing hours of care. This means rethinking how to be of value to clients and families across the entire care journey and exploring potential additional revenue streams from services beyond the fragile private-pay hour structure.

Start thinking more broadly today

The home care industry is projected to generate over $107 billion in revenue in 2025 with steady growth expected through 2032. Demand is soaring as nearly nine out of ten seniors want to age in place at home. However, rising costs, workforce shortages with a 77% caregiver turnover rate, and evolving family expectations mean the old way of doing business will not sustain home care agencies long term.

Forward-thinking agencies understand value is created by supporting families before, during, and after traditional caregiving hours. To do this well, agencies must evaluate their role to clients and families through a broader lens that includes engaging families early, helping them organize and share caregiving responsibilities even before formal services begin.

Engaging families early: a must for home care agencies

Most families start coordinating care tasks—meal prep, medication reminders, transportation, appointments—on their own, long before they look for and reach out to a home care agency. Often, the lack of education of the types of help available, the ‘we can do this on our own’ mentality, and cost considerations delay working with an agency even further. This can result in being reactive, overwhelmed, not to mention stressed, and missed steps and decisions for the seniors and their families.

Agencies can step in and differentiate themselves by offering pre-care support to families not quite ready to have agency caregivers come in, by offering services such as: 

• Complete an initial assessment and develop comprehensive family care plans that clearly outline care needs, assign responsibilities among relatives, and establish collaborative routines to avoid confusion and reduce family caregiver burnout. These plans should be personalized to reflect both the senior’s preferences and each family member’s capacity to contribute, with regular care team meetings to review progress and adjust.
• Offer interactive educational workshops focusing on practical caregiving skills, dementia care techniques, and effective stress management. These workshops should include expert-led demonstrations, real-world scenarios, open Q&A, and ongoing access to learning materials or follow-up support, empowering families to provide safer, more confident care.
• Conduct proactive home safety and readiness assessments to help families identify physical, medical, and environmental risks before they become emergencies. Trained assessors can provide personalized recommendations for home modifications, medication management, and fall prevention, ensuring loved ones remain secure while minimizing potential hospitalizations.
• Provide secure digital tools that enable family members and other care team members to communicate seamlessly, track appointments and symptoms, manage medication schedules, and assign tasks. These tools offer centralized access to shared records, real-time updates, appointment reminders, and can help coordinate backup plans and contingency support during health events.
• Create and deliver an integrated remote-care solution using in-home sensors to detect early signs of health or safety incidents—such as falls, changes in activity, or abnormal vital readings—sending timely alerts to both the agency and family. This system can be combined with regular virtual wellness checks or scheduled in-person visits, allowing for rapid intervention and improved peace of mind.

Including family engagement as part of the agency’s broader service strategy not only builds trust early and sets them up to convert to paying clients, but also establishes potentially new revenue opportunities such as subscriptions, memberships, paid workshops, and/or assessment fees.

The Future Growth Framework for Agencies

To build true resilience and long-term success, agencies can benefit from moving beyond a single-service mindset and adopt a three-stage growth framework—each tailored to meet client and family needs at every step, while opening up new revenue streams and deepening engagement:

1. Pre-Care Support (Before Care Hours Begin)
In this first stage, agencies lay the groundwork for trust and partnership by supporting families even before traditional caregiving starts. This may include an initial consultation and assessment, comprehensive family care plan development, access to professional care coaching, and workshops that build confidence and skills in families, relatives and friends who share caregiving duties. By offering readiness assessments, agencies help prevent crises and empower families with personalized guidance for their unique household situation. Only when the clients and families are ready – on their time frame – they can begin requesting help from agency caregivers.
Potential Revenue Sources: Memberships, subscription or program fees, and assessment services turn early engagement into sustainable, value-driven offerings.

2. Core Care Services (Traditional + Expanded)
Once care begins, agencies are already familiar with the client’s needs and trusted by their family. The agency is ready to deliver not only personalized support and companionship, but a spectrum of specialized programs addressing common client needs such as dementia care, specific chronic conditions, or transitional care following hospital stays. By bundling services or offering packages, agencies can differentiate themselves and meet each family’s needs as situations evolve over time.
Potential Revenue Sources: Hourly billing, premium for specialist programs, and bundled services enable flexible, scalable growth.

3. Ongoing Wellness & Technology Integration
Beyond the basics, agencies invest in long-term relationships by offering technology-enabled engagement, such as digital family engagement tools for real-time coordination and collaboration, remote monitoring devices to catch health or safety issues early, and regular wellness check-ins. These options can be layered with pre-care support and/or core care as appropriate to help agencies interact with families continuously and adapt quickly as needs shift, extending their relevance and value well across the entire care journey of the client.
Potential Revenue Sources: Subscriptions for digital coordination tools and wellness packages provide reliable, recurring income and strengthen client loyalty.

This layered, forward-looking approach positions agencies to stand out in a crowded and competitive market and thrive —serving as true partners across the entire care journey.

True partnership: staying valuable through the care journey

Agencies that commit to this framework can become true care journey partners, helping families navigate the evolving care landscape from the very beginning of the process. Early engagement embeds the agency deep within the client’s network, building trust and shared understanding before formal services even begin. As needs shift—whether due to changing health, family dynamics, or unplanned events—the agency remains a reliable touchpoint, adapting offerings to match each phase of care.

Maintaining strong partnerships means ongoing information sharing, collaborative decision-making, and shared responsibility for client well-being. Wellness services, technology-based monitoring, and regular care plan reviews help agencies stay connected to the family and the client, providing reassurance and identifying issues before they escalate. Agencies that prioritize this holistic approach are seen not just as service providers, but as trusted advisors and advocates for the family’s goals—resulting in higher satisfaction, reduced crisis management, and stronger long-term retention.

Why agencies must evolve now

With over 71 million Americans expected to be 65 or older in the coming years—and 70% projected to require some form of long-term care—the demand for home-based support is surging. The U.S. home care sector is projected to be one of the fastest-growing segments in healthcare, with most seniors expressing a strong preference to remain in their own homes as they age, fueling long-term demand for agency services.

However, this massive opportunity also comes with unprecedented challenges. Over 59% of agencies report ongoing caregiver shortages, and the workforce must grow by more than 30% just to meet forecasted demand. Turnover rates remain high, making continuity of care and business stability difficult. The current transactional model—focused exclusively on filling shifts and billing hourly—leaves agencies vulnerable to instability, high competition, and sudden revenue dips.

Agencies that proactively think about the needs of the ‘whole’ client throughout their care journey and creatively expand service offerings, deepen family engagement, invest in technology, and diversify their revenue have the opportunity to build the resilience necessary to thrive amidst both soaring demand and ongoing workforce and economic pressures.

Team Mariposa