The provider currently serves 15,000 patients across home care, hospice, and personal home care (PCS) service lines and is approaching half a billion dollars in revenue, Jackson stated during a recent HHCN+ TALKS interview.
The expansion follows recent acquisitions in Florida and the Pacific Northwest. Jackson indicated that the company is specifically eyeing further growth in the West, telling interviewers, “Go West, young man,” in reference to an upcoming hospice deal.
Strategic Market Expansion in Florida and the Pacific Northwest
Choice Health at Home has identified Texas, Arizona, and Florida as “pillar states” due to their burgeoning geriatric populations. According to Jackson, the company’s success in the Southwest—specifically in Maricopa County, Arizona, and Harris County, Texas—provides a blueprint for its entry into Florida.
Beyond the South, the provider has established a presence in the Pacific Northwest, including a new office in Seattle, Washington. Jackson noted that the clinical cultures in Seattle are similar to those in the company’s existing Denver, Salt Lake City, and Boise offices. The long-term goal is to build a business that can say it has taken care of people for 50 years, looking five years out with a foundation built on scale and financial strategy.
Integration of Home Health, Hospice, and Personal Care
The company operates by maintaining a balance of roughly 33% in each of its three segments: home health, hospice, and personal home care. Jackson stated that this diversification allows for a seamless continuum of care where technology triggers opportunities for a patient to move between service lines. For example, a PCS patient taking more time and assistance to clothe themselves should trigger an occupational therapy opportunity for that patient to be seen by the skilled arm.
Jackson explained that the company typically integrates a home health acquisition before pursuing a PCS or hospice deal to avoid overstressing operations teams. This approach ensures that acquired businesses are fully integrated, on the EMR, financial system, and human resources support system, and that the team is ready before new challenges are introduced.
Technology and AI in Clinical Documentation
Technology is moving fast to help integrate across its three service lines and enable clinicians to empower patients in their homes. Jackson reported that technology allows for insights, such as seeing when a CHF patient lacks an advance directive or has not had the power of attorney educated about the hospice benefit.
Jackson noted that for so many years in his career, technology was something nurses may or may not want to be engaged in, but now these are things people are just really excited about.
Navigating 2026 Regulatory Shifts and Reimbursement
The home-based care industry in 2026 has been rocked by regulatory shifts, an enrollment moratorium, Medicaid uncertainties from the One Big Beautiful Bill Act (OBBBA), and rapid technological advancements. Jackson described the proposed ruling as something they were really pleased to see, reflecting advocacy and awareness of where the patient wants to be.
Regarding Medicare Advantage, Jackson characterized avoiding it as “foolish.” He also addressed concerns about rural hospitals, stating that home-based care is a possible solution and that you need to be proactively running towards solutions in rural communities.
Jackson also addressed the Medicaid portion of the business under the One Big Beautiful Bill, noting that their PCS division is roughly 55% Medicaid and 45% private pay, providing diversity that makes Medicaid regulation less intimidating. He also pointed to a positive ruling in North Carolina with a rate increase and support in committee in Arizona.
M&A Criteria and Cultural Pillars
As the company continues its expansion, the focus remains on building density, integrating recent acquisitions, and pursuing new opportunities like the upcoming hospice deal in the West. Readers interested in home-based care can continue to follow industry updates and discussions through platforms like HHCN+ TALKS.
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