The Next Chapter for Pediatric Homecare: Insights from Two CEOs

Pediatric homecare is emerging as one of the most dynamic segments in healthcare services, driven by rising clinical acuity in the home, shifting payer preferences, and rapidly improving technology. To understand where the sector is headed, we spoke with Jessica Riggs, CEO of Angels of Care, and Mark Bush, CEO of Care Options for Kids, who offered firsthand perspectives on the forces shaping growth, the challenges operators must navigate, and the technologies redefining how care is delivered. 

What do you see as the biggest growth drivers in the industry over the next 3–5 years? 

Jessica Riggs: Nationally, there has been a clear and accelerating shift toward care in the home. Home-based care is more cost-effective, better aligned with family preferences, and increasingly capable of supporting higher clinical acuity. Advances in clinical practice and technology now allow care that was once limited to hospital or ICU settings to be delivered safely and effectively in the home. 

Looking ahead, value-based care represents one of the most significant growth drivers for pediatric homecare. High-quality pediatric homecare can improve outcomes while meaningfully reducing emergency room utilization, hospitalizations, and readmissions. As payers continue to prioritize total cost of care and outcomes, pediatric homecare is uniquely positioned to deliver both. 

Mark Bush: We’re observing a significant change in what’s possible for children with complex medical needs. More medically fragile kids can now safely thrive at home, surrounded by their families and communities, which is driving unprecedented demand for high-acuity nursing and therapy.  

At the same time, Medicaid programs in many states are becoming more supportive of home-based models, with expanded authorizations, greater flexibility, and improved reimbursement structures.  

Technology is another powerful driver. Purpose-built platforms help remove friction across intake, scheduling, communication, and documentation. This enables organizations to grow thoughtfully while focusing on what matters most: consistent, high-quality care delivered compassionately. When innovation aligns with the mission, it creates momentum that benefits families, clinicians, and payers alike. 

JM perspective: Both leaders highlight how more clinically complex children can now be safely cared for at home, and payers are increasingly supportive of models that reduce hospital use and improve outcomes. They also point to technology as a key enabler, helping providers scale efficiently while meeting growing demand for high-acuity pediatric care. 

What do you see as the biggest challenges in the industry? 

Jessica Riggs: Workforce availability remains one of the most significant challenges facing the industry. Recruiting, developing, and retaining highly skilled clinicians is essential, not only to ensure quality patient outcomes, but also to support the success of value-based care arrangements. 

We work closely with payer partners to develop reimbursement models that are sustainable for providers and meaningful for clinicians. On the Medicaid side, fragmentation across states creates complexity, with varying regulations, rate structures, and administrative requirements. Partnering with national payers and managed care organizations helps create greater consistency and allows us to serve more families efficiently across markets. 

Mark Bush: Workforce supply remains the biggest challenge, especially for high-acuity pediatric nurses. These clinicians do incredible work, and attracting, supporting, and retaining them requires genuine intentionality and kindness in how we design our systems and culture.  

Operating across multiple states also adds complexity. Each Medicaid program has its own rules, EVV (Electronic Visit Verification) requirements, and school-based care guidelines, which demand strong operational discipline and forward-looking infrastructure.  

While reimbursement has improved in some markets, it has not yet fully kept pace with the increasing acuity we see in today’s pediatric population. Solving these challenges requires close payer collaboration, optimism about what’s possible, and a relentless focus on doing what’s right for children and families. 

JM perspective: Workforce shortages remain the sector’s greatest challenge. At the same time, inconsistent Medicaid reimbursement adds operational complexity and limits growth, making strong payer partnerships and efficient multi-state execution essential to meeting rising demand. 

How have digital tools impacted or changed care delivery in your organization? 

Jessica Riggs: Digital tools have become foundational to how we deliver care. Staffing and utilization are critical drivers of quality outcomes, and we know that placing well-trained, high-quality clinicians in the home directly reduces hospitalizations and improves continuity of care. Technology enables us to ensure appropriate coverage, clinical oversight, and consistency across the care continuum. 

From a total cost-of-care perspective, technology also helps ensure families have seamless access to the services and resources they need, whether that includes appointment coordination, medication management, or broader care navigation. Since the COVID-19 pandemic, telehealth has expanded the ability to reach families quickly. Virtual supervision, remote monitoring and emerging AI-enabled tools allow for faster interventions, improved oversight, and more proactive care delivery, ultimately strengthening outcomes for medically complex children. 

Mark Bush: Digital tools have become vital to providing care. Integrated platforms reduce friction across intake, scheduling, communication, and field operations, allowing clinicians to spend more quality time with kids rather than on paperwork. AI is also driving significant improvements, especially in documentation, scheduling efficiency, and matching clinicians to the right cases.  

Telehealth and remote monitoring continue to expand access and improve care coordination, especially in therapy services. These tools enable faster interventions, more effective collaboration, and continuity of care across settings. When technology is designed with clinicians and families in mind, it supports community, improves outcomes, and ensures care is deeply compassionate. 

JM perspective: Digital tools now sit at the core of care delivery, improving speed, coordination, and overall quality. Technology is reducing administrative friction, enabling faster clinical interventions and more consistent access to services. This allows organizations to operate more efficiently while meeting the needs of medically complex children in the home. 

As pediatric homecare continues to evolve, it’s clear that the sector’s trajectory is defined by both accelerating demand and increasing operational complexity. Providers that can navigate the workforce shortage, deepen payer partnerships, and deploy technology to enhance both care quality and efficiency will be best positioned for growth. For investors, this creates a compelling opportunity: a mission-critical sector ripe with opportunity for operational improvement and value creation.