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What is the difference between a home health agency and a home care agency?

Aug 13, 2024 · 5 minutes to read

The terms home care and home health care are sometimes used interchangeably, but they refer to different types of in-home support. Home care generally means non-medical assistance with everyday living. Home health care refers to medical or clinical services delivered at home, often under a physician’s direction. Understanding the difference is essential for clients, caregivers and agency owners.

Home health care vs home care

What is a home care agency?

A home care agency provides non-medical support to people who need help with everyday home tasks. Typical services may include:

  • Bathing and grooming
  • Dressing
  • Toileting and incontinence support
  • Light housekeeping (cleaning, laundry)
  • Meal planning and preparation
  • Transportation or help with errands
  • Companionship and social support
  • Medication reminders (but not administration of prescriptions).

Caregiving under a home care agency is carried out by trained aides, personal support workers, or nurse aides who are not licensed medical professionals. These services are useful for individuals who need long-term assistance with daily living, including older adults, people with disabilities, and those who need extra support at home.

Home care is typically flexible in scheduling and can remain in place for months or years, depending on the clientโ€™s needs.

What is a home health agency?

A home health agency provides skilled medical and therapeutic care in a patientโ€™s home.

These services are often prescribed by a doctor or ordered after a hospital discharge. Home health care may include:

  • Skilled nursing care (wound care, injections, IV therapy)
  • Medication administration
  • Checking vital signs and monitoring health status
  • Physical therapy, occupational therapy, or speech therapy
  • Medical social work and care coordination
  • Home health aide services delivered under medical supervision.

Home health services tend to be short-term, designed to help patients recover from an illness, injury, or surgery and regain independence.

Agencies that offer home health care must meet state licensing requirements and often certification standards under Medicare, Medicaid, or other insurance programs. This allows them to bill insurance when eligible.

Comparison table

Feature or Service Home Care Agency Home Health Agency
Type of care Non-medical, personal support Medical or clinical, skilled care
Who provides care Personal care aides, support workers (non-licensed) Registered nurses, licensed therapists, and medical aides
Common services Bathing, dressing, grooming, meal prep, light housekeeping, companionship, errands, medication reminders Medication administration, wound care, IV therapy, vital sign monitoring, physical/occupational/speech therapy, and medical social work
Typical duration Long-term, ongoing Short-term, intermittent, or until recovery
Need for a doctorโ€™s order No Yes, often required for coverage
Payment / Insurance coverage Private pay, long-term care insurance, and sometimes Medicaid Medicare, Medicaid, private health insurance (if agency is certified)
Goal of care Support daily living and independence Restore or maintain medical stability and recovery

Why the difference matters for agency owners

For someone running or planning to run an in-home care business, knowing the difference between a home care agency and a home health agency affects many parts of operations:

  • Staffing and training: Home care agencies generally hire non-licensed aides for daily living support. A home health agency needs licensed nurses or therapists. Hiring, licensing, and training requirements differ accordingly.
  • Licensing and compliance: Home health agencies must meet stricter licensing and certification rules, especially if billing insurance, Medicare, or Medicaid. Home care agencies may have a lighter regulatory burden depending on state laws.
  • Business model and revenue streams: Home care often relies on private pay or long-term care insurance. Home health agencies may bill Medicare, Medicaid, or private insurers โ€” but only if properly certified.
  • Risk and liability: Providing medical services entails greater risk and liability. Agencies delivering skilled care must manage clinical liability, regulatory compliance, and quality control.
  • Client expectations and service planning: Clients (or families) need to know whether they need personal support or clinical care. Offering clarity helps match clients to the right service type without confusion.

Given those differences, a business owner must decide: Do I want to offer supportive care that improves quality of life, or do I want to provide medically skilled care that meets clinical needs? The right choice depends on the target population, staff capacity, compliance willingness, and funding sources.

Insurance considerations for home care and home health agencies

Operating in-home care โ€” whether non-medical or medically focused โ€” carries risks. A mistake, accident, or allegation of negligence could expose your agency to financial loss. That is why proper insurance is critical.

At BizInsure, we offer coverage tailored to home care and home health businesses. Some of the standard policies to consider include:

  • General Liability Insurance: Protects against third-party claims for property damage or bodily injury arising from care.
  • Professional Liability Insurance: Offers protection if a client claims harm or negligent care by your staff. This is especially relevant for medical or clinical services.

These insurance options help you manage unexpected costs and safeguard your business. Getting proper coverage can give you confidence in offering care and protect your long-term viability.

Get a quote for business insurance in minutes with BizInsure.

As with any insurance, coverage will be subject to the terms, conditions and exclusions contained in the policy wording. The information contained on this guide is general only and should not be relied upon as advice. The number of quotes provided varies between products, occupations and other underwriting factors determined by the insurers.
‘This information is a general guide only and does not take into account your objectives, financial situation or needs. Always check with your local licensing board when getting or renewing your [profession] license to ensure you are meeting their current licensing requirements.’
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