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Private equity has been circling home-based care for years, but PE investors’ specific interests have evolved as the home-based care industry and broader health care ecosystem have changed.
Bloomberg this week reported on the recent $3 billion acquisition of TEAM Services Group by General Atlantic, reportedly at a 10x multiple, offers a clear signal that investors are willing to pay a premium for a certain type of company in today’s market. g More specifically, General Atlantic is betting on a tech-enabled, infrastructure-heavy platform that also includes a sizable – and scalable – care provider business.
By pairing direct care delivery with scalable financial management services, TEAM has moved beyond being a traditional provider to become a diversified infrastructure powerhouse.
In this week’s exclusive, members-only HHCN+ Update, I’ll dive into the TEAM deal, offering analysis and key takeaways including:
– Why I believe General Atlantic paid a premium for the company
– How TEAM turned Medicaid consumer-directed care into a high-value asset by sitting adjacent to reimbursement risk
– How the 24 Hour Home Care acquisition transformed TEAM from a service provider into a full-stack home care platform capable of rapid M&A
Private equity interest in home-based care
In home-based care right now, most smaller providers have valuation ranges of 3x to 5x, Jen Lentz, the CEO of Avid Health at Home, recently said at HHCN’s Capital+Strategy event. Companies that reach the “sweet spot” of 7x to 10x have to be exciting and boast significant strategic value, she continued.
TEAM reached the top of that sweet spot with its reported 10x valuation. General Atlantic has not replied to my requests for comment, but I suspect that the valuation is due in large part to TEAM’s embodiment of a trend HHCN has been tracking. I often hear about, and have written about, the importance of diversification. Usually, this means payer diversification, diversifying into specialty care offerings or diversifying into new service lines. But TEAM is not a traditional home care platform. A sizable chunk of its value is business infrastructure, from payroll and human resources offerings to financial management services for self-directed Medicaid programs.
TEAM is not the only example of meaningful private equity interest in the home-based care space currently. So far in 2026, Kinderhook Industries acquired Enhabit Inc. for $1.1 billion, and Elara Caring received a strategic investment from Ares’ Private Equity Group (NYSE: ARES) and DaVita (NYSE: DVA), a kidney care provider.
But the TEAM deal is unique insofar as the business involves financial management services and payroll infrastructure, national scale and government program involvement. Compared to most home-based care providers, TEAM is highly risk-insulated in terms of having multiple business lines that are not subject to the whims of those who control the reimbursement, regulation and legislation governing providers. And I’m betting that’s why General Atlantic was so interested in the company.
Before I conjecture a bit here, a reminder that General Atlantic declined my request for comment on the deal. But looking at the firm’s health care portfolio, it often focuses on the tech-enabled side of health care and organizations that have an infrastructure element. Its care delivery investments are often wrapped in technology, data-driven models or a focus on value-based care. For instance, one of its portfolio companies, Stellar Health, is a value-based care enablement platform that works with health plans and provider groups to align incentives. Oak Street Health, another company designed to keep older adults in their homes longer, operates on value-based care models.
Medicaid and consumer-directed care as highly investable
Given the deep level of uncertainty surrounding Medicaid due to the One Big Beautiful Bill Act (OBBA), I’m about to say something surprising: I think General Atlantic was interested in TEAM, in part, because of the relative security of TEAM’s Medicaid involvement.
Of course, I’m aware that Medicaid-funded home care is currently in another stage of turmoil, with a deep focus on fraud in the space remaining top of mind for Centers for Medicare & Medicaid Services (CMS) Administrator Dr. Mehmet Oz.
But TEAM offers financial management services tied to Medicaid self-directed care programs, which means these services lack clinical risk and are highly scalable. So, TEAM represents a nuanced Medicaid bet. Instead of taking on reimbursement risk directly through care delivery, it sits adjacent to it. It captures administrative revenue tied to the growth of self-directed care without being exposed to the same margin compression and compliance burden facing traditional Medicaid providers.
Still, it’s important to note that financial management services for Medicaid consumer-directed care have received some less-than-desirable publicity in recent history. HHCN has reported on class-action lawsuits and the closures of home care companies related to New York’s self-directed Medicaid home care program’s transition to a single fiscal intermediary. Public Partnerships LLC (PPL), the company that was chosen as the program’s only fiscal intermediary, has since published its own data showing high levels of overall satisfaction, but the lawsuits, protests and CMS review remain reputational headwinds.
So, the self-directed care space comes with its own risks. Still, the opportunity for growth is substantial. Self-directed Medicaid HCBS models are now available nationwide, involving more than 1.5 million people in 2023, according to MACPAC. And especially with staffing shortages pressing providers, self-directed care is poised to expand, insofar as some programs allow for family caregivers to receive payments.
24 Hour Home Care’s role
I’ve been talking a lot about TEAM’s more diversified offerings, but it’s critical to think about its actual care offerings. TEAM employs 100,000 caregivers and household staff – it’s a huge player in the space. The company’s acquisition of 24 Hour Home Care played a key role in TEAM’s development as a true home care platform – and laid the foundation for the company’s $3 billion investment.
The 24 Hour Home Care acquisition, which involved more than 11,000 caregivers and 13,000 clients, positioned TEAM to scale in new states and service lines. 24 Hour Home Care had a vision of becoming the largest home care provider in the U.S., and saw the TEAM deal as a way to accelerate that goal through TEAM’s acquisition expertise. And it did so, one example of which is its acquisition of Inteli-Care in 2022.
The acquisition enabled TEAM to grow as a full-stack home-based care platform. This diversification doesn’t eliminate risk but it distributes it in a way that many single-line home care providers cannot. That hybrid model, combining scalable infrastructure with direct care delivery, aligns closely with the types of platform investments General Atlantic has historically pursued, particularly those that can compound growth through both organic expansion and M&A.
And that’s my biggest takeaway from this deal: Investor interest was likely not just driven by health care’s evolution into the home, but because TEAM’s full-service offering offers several entry points into this site of care while also spreading risk and creating multiple springboards for further growth. That’s not an easy formula for other at-home care providers to replicate, but it highlights that even while demand for home-based care surges, the most profound opportunities for growth go beyond simply delivering care and involve controlling more aspects of the increasingly complex web of clinical services, payment mechanisms and business needs defining this market.