Cornell Report Analyzed Private Equity in Home Care
New data on agency employment practices highlights wage and expense concerns for owners.
Updated on Oct. 6, 2026 in Employment
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Cornell University researchers published a study examining working conditions at five private-equity-owned home care agencies in New York. The findings, based on interviews conducted between April 2025 and March 2026, outline concerns regarding payroll accuracy and worker out-of-pocket expenses.
Why it matters
The report highlights growing operational scrutiny of private-equity-backed home care agencies, which captured 7.6% of state Medicaid home care revenue as of 2022. For operators, the data underscores the risks of administrative friction and labor management issues in this increasingly consolidated sector.
The study included 40 interviews, comprising 25 home care workers and 15 industry representatives, reflecting a 7.6% market share of Medicaid home care revenue held by private-equity-backed agencies in 2022. It remains unknown how these practices compare against non-private equity firms.
The players
Cornell University
An Ivy League research institution that examines labor market trends and workplace policy.
Robert Wood Johnson Foundation
A philanthropic organization focused on healthcare system research and public health initiatives.
The details
Researchers recruited participants through worker organizations and social media to analyze labor conditions across New York. Workers reported hourly wages between $17.50 and $22, while describing systemic payroll errors and missing promised supplements. Additionally, many staff members reported using personal funds to cover transportation costs for their clients, suggesting potential gaps in organizational expense management systems.
Timeline
In 2022, private-equity-backed agencies accounted for 7.6% of Medicaid home care revenue.
The research team conducted interviews from April 2025 through March 2026.
Cornell University released the Worker Institute report on October 6, 2026.
Market Landscape
This study follows a pattern set by New York's Medicaid home care reimbursement program as scrutiny of private-equity activity in the sector grows. The findings add a granular labor perspective to the state's broader regulatory discussions on agency financial administration.
Owners should review payroll auditing processes to ensure compliance with promised supplements and wages. Managers should also evaluate whether current expense reimbursement policies adequately cover necessary staff transportation costs to prevent labor retention issues.
The takeaway
The study suggests that payroll consistency and clear expense reimbursement are essential metrics for agency operators in a high-scrutiny environment. Monitoring these specific indicators can help firms avoid the operational friction identified in the report.
Further reading
For broader trends on staffing and labor dynamics, see the Employment section.
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Do you trust that private equity ownership improves the quality of local home care services?
