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Run the Payroll Fee Auditor →Blog · Payroll Management · Home Health
Home Health Agencies: Managed Payroll for Small Businesses (Under 25 Employees) (2026)
Managed payroll at $25-$45 PEPM all-inclusive makes economic sense at nearly every size for home health agencies, but the specific value drivers differ depending on headcount.
Payroll at Different Sizes for Home Health Agencies
| Home Health Agencies Size | Monthly Cost | vs. In-House Hire |
|---|---|---|
| Small agency (10-25 caregivers) | $250-$1,125/mo | Save $53K-$83K/yr |
| Mid-size agency (25-75 caregivers) | $625-$3,375/mo | Save $45K-$73K/yr |
| Regional agency (75-200 caregivers) | $1,875-$9,000/mo | Save $25K+/yr |
The comparison is against an in-house hire at $55,000-$85,000 fully loaded to $57K-$88K per year.
Under 25 Employees: The Clearest ROI
For home health agencies under 25 employees, in-house payroll cannot be justified. A payroll coordinator costs $55,000-$85,000 fully loaded -- compared to $625-$1,125/month for managed payroll. The savings pay for a year of managed payroll in the first 2-3 months.
25-75 Employees: Complexity Drives the Case
In the 25-75 employee range, home health agencies are dealing with more visit-based aide pay, travel time reimbursement, Medicaid billing vs payroll, live-in caregiver rules. An in-house generalist is less likely to have the depth needed in these areas. Managed payroll provides specialist coverage that reduces exposure.
75-200 Employees: Hybrid Approaches Emerge
At 75+ employees, home health agencies often consider a hybrid approach: an HR generalist handles employee relations and benefits while a managed payroll provider handles the compliance-heavy payroll function. This keeps an internal HR presence while outsourcing the most technically complex piece.
How to Get a Quote for Your Home Health Agencies
BEG quotes managed payroll based on your actual headcount and pay frequency. For most home health agencies, the first discovery call includes a custom cost comparison against your current setup.
Managed Payroll, Handled.
BEG manages payroll at $25-$45 per employee per month, all-inclusive. Get an instant cost comparison for your business.
Frequently Asked Questions
Can you handle visit-based pay for home health aides?
Yes. Aides paid per visit are set up as hourly employees with a per-visit rate. Visit logs from your scheduling software are the input for pay calculation, and we ensure per-visit pay meets minimum wage for time including travel between clients.
How do you handle travel time between client visits?
Under DOL guidance, travel time between client sites is compensable and must be paid at minimum wage. We include it in the total hours calculation for overtime purposes.
Can you handle multi-state operations?
Yes. Home health agencies serving clients across state lines register in each state, handle state employer setup, and file required returns in all applicable states.
What does BEG charge for home health agency payroll?
Home health payroll runs at $25-$45 per employee per month. Visit-based pay, travel time tracking, and Medicaid reconciliation reporting are all included. For an agency with 30 caregivers, that is $750-$1,350 per month.
Related Resources
Anthony leads payroll solutions at Business Executive Group, a national managed payroll firm serving businesses across industries including Home Health Agencies. BEG manages payroll at $25-$45 PEPM, all-inclusive, with deep expertise in compliance, multi-state filing, and industry-specific payroll requirements. Get instant pricing at beghr.com.
Authoritative source: U.S. Department of Labor: Wage and Hour Division
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