No matter the industry, return on Investment (ROI) is one of the only metrics that matters when you’re running a business. However, home care agencies must face the unique challenge of providing high-quality, personalized care for clients while maintaining operational efficiency.
For larger, multi-location agencies, maintaining operational efficiency becomes even more complex: leaders must maintain consistency, compliance, and efficiency across locations, programs, and teams while maintaining visibility at all times.
The path to improve ROI is paved with resource optimization and cost reduction, and in a less direct yet equally impactful way, increased client satisfaction. Happy clients will stay with your agency for the long haul and refer others in the process, keeping your revenue and cash flows healthy. In that same vein, retaining caregivers (i.e., decreasing turnover) will save plenty on hiring and training costs. That’s found money that can be poured right back into the business.
For enterprise-level agencies, both client satisfaction and caregiver retention are tied to operational consistency across regions; requiring real-time insights and standardized processes.
Here’s how a comprehensive tech solution that integrates scheduling, billing, visit verification, and communication tools can help streamline operations and ensure airtight compliance.
Method 1: Use Healthcare-Specific ROI Metrics
To truly understand and improve your ROI, you’ll need to go beyond generic financial metrics and focus on specific data that reflects the realities of running a home care business: revenue per caregiver, payroll costs relative to hours of care delivered, Electronic Visit Verification (EVV) compliance rates, and caregiver turnover can all help agencies understand what’s working, what’s not, and where strategic changes can yield stronger returns.
Enterprise organizations require real-time visibility into these metrics across all locations, not just individual offices. Without unified and customizable reporting, leaders spend too much time consolidating data manually, slowing decision-making, and obscuring performance trends that affect profitability.
Focus on Cost Management
Agencies often focus too heavily on high-level costs like payroll and overhead. In the meantime, “hidden” expenses are quietly chipping away at their margins.
Administrative inefficiency is one of the largest money pits for home care agencies. When tasks like caregiver scheduling and data entry are coordinated without the help of technology, teams leave themselves vulnerable to waste. Duplicate data entry, unfilled shifts, and other pitfalls can lead to wasted staff hours, billing delays, and even missed appointments.
These inefficiencies are magnified across multi-site locations. One office struggling with scheduling or billing can create ripple effects that slow cash flow, distort performance metrics, and impact reporting accuracy across the organization.
Another way for agencies to rack up additional expenses is noncompliance with EVV or state regulations. If you fall out of step with these requirements, you may be stuck with costly penalties or reimbursement denials. These costs aren’t always obvious on a basic financial report, but they can quickly eat into your bottom line if they’re not actively prevented.
This is especially true for multi-state agencies that must navigate different EVV aggregators, visit rules, and documentation requirements, making centralized oversight essential.
Diversify Payers for More Stability
There’s a reason why investment portfolios are composed of multiple stocks and why farmers plant a host of different crops across their acreage. Diversification means you’re not relying on a single source for your company’s success, and in home care, payer source diversification is an important financial strategy.
If your agency leans on a single payer, you’re not guaranteed to run into trouble. But your ROI can suffer if that source hits turbulence – for example, changes to Medicaid funding or a recession that cuts into clients’ private pay budgets. Adding more pillars to your payer base can only serve to reinforce your financial health, and is well worth the initial effort of branching out in a new direction.
Enterprise teams need payer diversification supported by real-time revenue forecasting, denial tracking, and reimbursement visibility at scale. Without a unified system, leaders struggle to identify payer-specific risks early enough to mitigate them.
Method 2: Optimize Scheduling & Operational Efficiency
Scheduling might not jump to mind as an ROI-boosting opportunity, but this routine task is fertile ground for operational improvements. Matching the right caregivers with the right clients at the right times makes the best use of the limited resources at your disposal. It also reduces the drive time between appointments, so you can fit more visits into each shift.
When scheduling is running smoothly, all stakeholders are better off for it. For starters, clients are seen on time at a frequency that fits their needs and by a consistent caregiving team. At the same time, caregivers can enjoy greater predictability and much less organizational friction throughout the workday.
Since switching to AxisCare scheduling software, one agency was able to give 88% of its caregivers more than 70% of their Preferred Work Hours. This had a direct impact on its employee retention, with caregivers staying on board for an average of at least 90 days.
The stakes are often higher for enterprise organizations: scheduling inefficiencies compound across branches, leading to inconsistent utilization rates, unnecessary overtime, and unreliable performance forecasting. Centralized, real-time visibility enables leaders to reduce cost leakage and standardize resource allocation across markets.
Method 3: Integrate Compliance With EVV
EVV is a federally mandated information tracking system for all Medicaid personal care services (PCS) and home health care services (HHCS). It logs data like appointment location, start and end time, and services rendered in a standardized format that is then used for reporting and billing.
These traceable and tamper-evident records safeguard against penalties and lost revenue due to non-compliance. When data entry is left to caregivers, it’s also vulnerable to human error: manual logs may have missing or incorrect information, and among a flurry of appointments, they may not be submitted on time. EVV ensures service details are accurate, complete, and submitted in real time so agencies can avoid billing discrepancies that can trigger audits or payment delays.
Enterprise agencies need EVV systems that can normalize data across states, aggregators, and programs while maintaining consistent compliance standards enterprise-wide. Variations in state rules introduce operational risk, and without centralized visibility, leaders cannot reliably enforce compliance or predict reimbursement outcomes.
Use Technology for Long-Term Gains
Adopting EVV and other home care technology offers immediate benefits, such as reduced day-to-day friction and simplified operations. But in the long term, even more ROI can be unlocked.
Proper training will teach team members how to maximize the value they extract from these tools, and even pave the way for them to optimize their workflows in creative ways. As time goes on, tracking usage and compliance metrics lets agencies verify that the system is being used as intended while highlighting areas for ongoing improvement.
For enterprise teams, the long-term gains expand further: standardized workflows, consistent documentation practices, and centralized system governance protect margins and reduce operational variability across locations.
Method 4: Strengthen Communication & Staff Retention
It’s difficult to express the value of communication in numbers, but we know this: when caregivers, clients, and in-office teams struggle to connect, it leaves everyone feeling frustrated and ready to throw in the towel. On the ground, that translates to staff turnover and client attrition.
Keeping caregivers in the loop through active communication alleviates stress and boosts morale, creating a better-equipped and clearer-eyed workforce that can deliver improved patient care. In turn, clients feel well-served, and feelings of confidence can grow between them and their caregivers.
Fragmented systems increase risk, complicate incident management, and create inconsistent experiences across markets. A single communication framework ensures standardized expectations, faster risk mitigation, and clearer accountability.
Attract & Retain Clients With Confident Staffing
Home care is inherently personal. As a client, you have practitioners entering your personal space and helping you with tasks or challenges that may feel vulnerable. Meeting with the same caregiver regularly is an essential part of building trust and retaining clients; familiarity is an important part of building a healthy and sustainable routine, and a reliable client base is a boon for ROI and your bottom line.
Enterprise leaders rely heavily on staffing insights to ensure consistent caregiver-client matching across regions. Without accurate, integrated data, client experience becomes fragmented and difficult to scale.
Method 5: Leverage Data-Driven Insights for Lasting Growth
Maintaining a healthy ROI is a lifelong effort for agencies, and analytics are your North Star. Setting up and monitoring dashboards that detail the success of your operational and marketing efforts is the key to refining ROI. Over time, day-to-day performance data can be transformed into actionable insights.
With the right dashboards in place, you can track everything from how efficiently you’re allocating your human resources to which referral sources are sending you the most clients. This visibility helps you organize your efforts more effectively, whether that means adjusting your marketing spend, optimizing staff schedules, or focusing on high-performing referral channels.
Analytics must go far beyond office-level reporting. Leaders of enterprise agencies need real-time data pipelines, standardized KPIs, multi-location performance visibility, predictive insights, and audit-ready reporting. Without this, strategic planning becomes reactive rather than proactive, slowing growth and obscuring risk.
Achieve Operational Excellence & Improve ROI With AxisCare
AxisCare’s advanced features – like our intuitive scheduling system, seamless billing integrations, and reporting capabilities – can all help shape a winning ROI strategy. Request a free demo today to learn more about how we can support your agency’s financial health in the long term.
