Our analysis of Medicare home health cost reports reveals that the average unduplicated total census was 725 patients per agency, but this number does not tell the whole story.

Executives often use the concept of average to gauge their own performance (i.e. “Is my company’s marketing performance above average or below average?”). Any time you are trying to summarize a monetary situation in the U.S., average is rarely what most people are doing.

Average Unduplicated Annual Census

National Average: 725

National Median: 294

The mathematical value of median often does a better job of showing what most people are doing in terms of money. Average is calculated by adding up all the home health census totals in the nation and dividing by the number of agencies. Median means you line up all the
totals in order, and the median is the total in the middle. The median home health agency in the U.S. reported 294 annual patients.

Why is the median so far away from the average? The top 20% of home health agencies see 77% of the nation’s home health patients. In other words, 80% of the nation’s home health agencies see only 23% of the nation’s home health patients! Nationally, the mathematical
calculation of average does not reflect “normal.”

While having the majority of patients served by a minority of agencies characterizes the industry nationwide, this scenario does not hold true in every market. Individual markets in the U.S. vary widely in terms of whether the patient load is dominated by one or two providers or spread out among multiple providers.


The scenario of industry dominance by 20% of providers and 80% of providers seeking to change that situation underscores the importance of keeping and cultivating the referral sources an agency already has.  The Referral Doubling Strategy focuses on cultivating your referral base and bolstering loyalty.  Follow the link in the menu above for more information.