First-Ever U.S. Home Health Agency Rankings Reveal Stark Quality Gaps

U.S. News & World Report has published its first-ever rankings of home health agencies across the United States. The ratings assess over 12,000 Medicare-certified providers, grading them on clinical quality and patient feedback. Only a fraction of agencies earned the highest marks, with many states struggling to meet top standards.

The evaluation comes as the sector faces severe staffing shortages and rising demand from an ageing population. Experts warn that families should plan for home care needs well before hospital stays to secure quality support.

The new ratings system scores agencies on a 1.0 to 5.0 scale, dividing them into three categories: high-performing, as expected, or evaluated. Out of those assessed, 1,319 received the top 'best home health' designation, while 5,288 met baseline standards. Another 4,233 agencies lacked sufficient data and were not rated at all.

Performance gaps were clear in key areas. At top-rated agencies, 93% of patients improved their mobility—walking and moving better—compared to 83% nationally. These agencies also helped more patients regain independence in daily tasks like getting out of bed, bathing, and managing medications. Timeliness was another strength: 99% of patients at high-performing agencies started care on schedule, versus 94% across the country. California led with 151 top-rated agencies, followed by Texas and Florida. However, several states had very few high-performing providers, and some had none. The rankings arrive as the industry grapples with chronic staffing shortages, driven by low wages (typically $15–18 per hour), physically demanding work, and high turnover rates of 40–50% annually. Immigration policies add to the strain. Around 25% of home care workers are foreign-born, but stricter visa rules in 2025–2026 will likely reduce the workforce further. Medicaid reimbursement rates also remain too low to raise wages, while burnout rises due to heavier caseloads and more complex care needs. Experts recommend families research local agencies early and discuss options with doctors before hospital discharge. The ratings aim to help patients identify reliable care, but the broader system still faces significant challenges.

The first 'Best Home Health' ratings highlight stark differences in care quality across the US. While top agencies deliver better outcomes, many regions lack access to high-performing providers. With demand growing and staffing shortages worsening, families are urged to plan ahead for home care needs.

The data also underscores systemic issues, from low pay and high turnover to immigration barriers and funding constraints. These factors will shape the availability and quality of home care in the coming years.