WACO, Texas—Increasing financial pressure has more homecare agencies concerned about their profitability, according to a new survey from software provider AxisCare.
More than 300 industry leaders from homecare agencies across the United States completed the survey on their current experiences, challenges, and future trends in homecare, which was conducted by Leading Home Care, a Tweed Jeffries company. Participants included a mix of agency sizes and roles, including owners, executives and employees.
"For the third consecutive year, client affordability and rising costs of staff, supplies and services remain the most significant obstacles to growth, with 61% of industry leaders rating these challenges as a very big or extreme hindrance to their ability to expand and serve their communities," AxisCare said in a release. "The findings also highlight how economic pressure and rising costs are reshaping agency growth priorities in 2026, with leaders increasingly focused on optimizing performance within existing markets rather than expansion."
Key findings from the survey included:
- Profitability concerns increased sharply from 13 % to 34%, reflecting increasing financial pressure across the industry
- 65% of agencies identified improving performance in their current market and attracting new clients as the greatest growth opportunity
- Caregiver shortages remain the top pain point, but concern declined from 59% to 53%, signaling improvements in recruitment and retention efforts
The survey also made note that respondents feel artificial Intelligence (AI) is no longer emerging; it is operational. Cited by 65% of respondents, AI is the leading technology trend in homecare, and respondents noted it is expected to deliver the greatest impact through client and caregiver shift matching and automated scheduling. The survey also found that federal policy changes are expected to significantly influence agency growth. More than 45% of respondents said the One Big Beautiful Bill Act will have a significant impact on their ability to scale, with 55% citing the Medicaid provider tax reduction as the biggest operational challenge.
"This year's survey shows an industry getting smarter under pressure," said Todd Allen, CEO of AxisCare. "Homecare agencies have shifted from expansion-focused strategies to sustainable growth powered by technology. We're seeing AI move from nice-to-have to essential, helping agencies support their caregivers and deliver better care with the resources they have."
Download the full report: The Future of Home Care: A 2026 Survey of the Home Care Industry & Future Trends.