How The Independent Horizon Care Services Is Zagging In A ‘Ruthless’ Florida Home Care Market

In a day and age where more private-pay home care providers are trying to lock in up-front payments and longer commitments from clients, Horizon Care Services is trying to double its revenue through more flexibility, not less.

More flexibility, both for itself and for clients.

Andrea Albertini, the CEO of Horizon Care Services, started the company two decades ago in Florida’s Palm Beach County. After moving there from Philadelphia – where she held an array of positions within home-based care organizations – she saw an unmet need in the market for high-quality, private-pay home care.


The company was started on the back of some savings, credit and a $50,000 loan from a friend. In short order, its annual revenue eclipsed $1.5 million.

“I wanted things to be done my way, which is the right way – looking at a patient holistically,” Albertini told Home Health Care News. “It’s not just about taking care of a wound, or just an IV. It’s about finding out what else a patient needs – what they eat, if they live alone and who cleans their house.”

Horizon Care Services has two locations, one in Palm Beach County and one in Broward County. It has about 200-250 caregivers actively working on home care cases, which are exclusively paid for out of pocket or through long-term care insurance. About 60% of the company’s caregivers have been with the company since it started.


At one point, the company expanded to a few other areas in Florida, but Albertini found it hard to keep her finger on the pulse of each location enough to justify the geographic expansion.

“It was too much, and I wanted to be able to concentrate on these two areas,” she said.

These days, the company does anywhere between $6 million and $7 million in sales in home care. It also offers care management, medication management and some other ancillary services.

Albertini has also launched other correlated businesses, such as a mobile physician clinic and a senior placement service. Down the road, she sees all three of those businesses interacting with each other, creating a larger care continuum and seamless transitions for clients.

For growth within home care specifically, Albertini doesn’t see it coming through expansion. For one, the business is still privately owned. There’s not a financial backer pushing de novos or acquisitions.

She sees it coming through targeting certain segments of the population in Florida. For instance, Horizon Care Services has been vetted and chosen as the go-to home care provider for multiple country clubs in Palm Beach and Broward.

“I think we’re in a wonderful position right now to double revenue the next couple of years,” Albertini said. “We’re going into a lot of high-end country clubs. We’re already in three of them, and that’s going to be with the mobile physician practice, with home care, and with our senior placement.”

One of the hurdles to growth is finding the right salespeople, Albertini said.

Home care sales is not just hard work, but it’s also specific. Not every salesperson that comes into home care understands the ins and outs of the industry as much as they need to.

“That’s my biggest challenge, finding the right people that really want to sell home care,” she said. “Home care is very competitive in the state of Florida, to be honest with you. But when it comes to competition, I don’t think we have much in terms of the level of care we provide.”

Maintaining flexibility

Horizon Care Services has a lot of flexibility. It can adjust prices because it mostly takes private pay. It can adjust wages to accommodate for more senior-level caregivers, even on a case-by-case basis. It can grow how it wants, and as it pleases. Albertini calls all of the shots.

The billing rates have risen for everyone in home care since 2020, but the agency has done its best to keep costs down.

That’s partly because of what Albertini sees other companies doing. Specifically, she brought up other agencies forcing clients to put down as much as $5,000 to start care, or to sign a one-year contract for services.

“There’s all kinds of that stuff that’s going on in this business,” she said. “They’re having people sign a one-year contract. They’re not apartments, they’re people. And I think that’s awful. People are just getting ruthless in the state of Florida. But I love my agency. I’m not going anywhere anytime soon. I have wonderful caregivers. And I’m going to continue to try to make a difference for the people that I can serve.”

Billing rates for Horizon Care Services vary based on the type of client and where the client is located, but they’re generally between $26 and $30 per hour, according to Albertini.

As opposed to chasing after a 50% profit margin, Albertini strives for a 30% to 35% one, and puts the other revenue back into the business and back into the caregivers. At her discretion, she’ll help out certain caregivers who need it in dire situations.

Albertini continues to look for ways to drive the business forward. But, in the end, it’s the relationships that she believes are Horizon Care Services’ biggest advantage.

“It’s about building relationships,” she said. “Is the product a bonus? Yes, having a good product to sell is wonderful. It helps you. But really, if you think about it, it’s still about the person.”

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