Best Home Care Agency Software in 2026: An Honest Comparison

Nine home care platforms compared for non-medical agencies with 5 to 200 caregivers: what each is built for, what it publishes about price, where its EVV and AI stand, and which fits your size. Hailo wrote this guide, so read the Hailo section with that in mind.

By the Hailo teamUpdated September 3, 202611 min read

What changed in home care software in 2026

Five years ago a home care platform was a scheduler with a billing module attached. In 2026 the category has split. The established all-in-one systems (AxisCare, CareSmartz360, WellSky Personal Care, AlayaCare, HHAeXchange) have layered AI assistants and predictive analytics on top of mature scheduling, EVV and billing. A newer group (ShiftCare, Hailo) competes on published pricing, self-serve signup and AI that does front-office work.

Two other things moved. Caretime stopped selling under its own name and now sends new agencies to Alora Health. And EVV stopped being a differentiator: every platform here does GPS or telephony verification, so the real questions are which state aggregators are live and whether a caregiver can clock in with no signal.

This guide is for owners and administrators of non-medical US agencies with roughly 5 to 200 caregivers. A note on bias: Hailo publishes it. We describe every product from its own website and list the pages we used at the end.

The 2026 comparison at a glance

"Best for" reflects who the vendor says it serves. Published pricing is what the vendor prints on its own site.

Tool	Best for	Published pricing	Notes
AxisCare	Established private-pay and Medicaid agencies, franchises	On request (tiered by client count: up to 15, 15 to 500, 500 to 1,000, 1,000+)	All-in-one plus managed Medicaid and VA billing. Axi AI assistant. No free trial.
CareSmartz360	Growing and multi-location agencies, franchisors	On request (per active client; tiers 0 to 100, 101 to 249, 250+)	EVV telephony and GPS included, 45+ state EVV integrations, AI voice bot confirms shifts.
WellSky Personal Care	Enterprise and franchise private-duty agencies	On request	Formerly ClearCare. HITRUST certified, 4,000+ agencies, SkySense AI, Family Room portal.
AlayaCare	Mid-market to enterprise, multi-state, mixed payer	On request (three tiers, no prices)	AlayaFlow AI agents for intake, scheduling, clinical and billing. 770+ global clients.
Alora Home Care	Agencies that also run skilled home health or hospice	On request (by users or patients)	21 years in business, all-payer billing, GPS and telephony EVV, offline mobile. Now home to Caretime.
ShiftCare	Small agencies, IDD and HCBS providers	$9, $15 or $25 per user per month ($8, $13, $20 yearly); 5-user minimum	7-day free trial. Sandata EVV, offline caregiver app, smart matching and job board on Growth and up.
Caretime	Existing Caretime customers only	On request (via Alora)	No longer sold under its own name. New agencies go to Alora; existing customers keep their terms.
HHAeXchange	Medicaid agencies in states where it is the EVV aggregator	On request	32,000+ US providers, 180+ MCOs, 30 state Medicaid programs. Case broadcasting. CarePay payroll.
Hailo	Independent agencies, 5 to 200 caregivers, wanting published pricing and an AI front desk	Free $0; Core $99/mo; Operations $199/mo (unlimited clients and caregivers); Enterprise custom	AI office manager answers calls 24/7, CRM, recruiting, scheduling with EVV and offline clock-in, lead marketplace. Newest vendor here.

How to choose

Most bad software decisions in home care come from buying for the agency you hope to be in five years rather than the one you run today. A 12-caregiver agency does not need franchise dashboards. A 150-caregiver Medicaid agency should not pick a tool for its free tier.

The checklist

Payer mix. Mostly Medicaid: the state aggregator and claims workflow matter most. Mostly private pay: CRM, intake and family billing matter most.
Pricing model. Per client, per user, or flat. Model the cost at today's census and at double.
EVV in your state. Which aggregator is live today, not on the roadmap? What happens with no signal?
Call-off coverage. How many clicks from "caregiver called in sick" to "replacement confirmed"?
The front office. Who answers the phone at 7 PM? Most platforms assume you have a receptionist.
Recruiting. An applicant pipeline inside the product, or an integration to a separate ATS you also pay for?
Mobile apps. Caregiver app with offline mode plus a family portal. Check the app store ratings yourself.
Exit cost. Can you export clients, caregivers, visits and notes as CSV without a support ticket?

A four-step evaluation

Write down your three most expensive recurring problems. Score every vendor on those three only.
Get the pricing formula in writing at your current census and at double.
Run one real week of schedule changes in a trial, including a same-day call-off, with your actual scheduler at the keyboard.
Call support once with a real question and time the answer.

AxisCare

AxisCare is an all-in-one platform for home care, skilled care and IDD providers, organized by agency size from "up to 15 clients" to "1,000+ clients". Its pricing page says the base subscription includes scheduling, EVV, billing, the caregiver app, custom forms, client and family portals, two-way chat and custom reporting. Applicant onboarding, CRM, payroll and AI call transcription come through an integrations marketplace.

Two things stand out: AxisCare Intelligence (Axi, an AI chat assistant, plus care analytics and AI caregiver matching) and managed revenue cycle services where AxisCare staff handle Medicaid and VA claims. Customer stories lean on franchise brands and the site cites 350,000+ users. Pricing is on request with no free trial. A small private-pay agency pays for a lot it will not touch, and no inbound AI receptionist is listed.

CareSmartz360

CareSmartz360 is aimed, in its own words, at "growing and multi-location home care agencies". Pricing is per active client, with tiers for 0 to 100, 101 to 249 and 250+ clients plus a franchisor package. The rate is unpublished, but the pricing FAQ is specific about inclusions: EVV via telephony and GPS with no per-minute fees, scheduling, billing and payroll, custom forms, care plans, family and caregiver portals, a training library and a caregiver app in seven or more languages.

Its AI Hub is the most concrete among the incumbents: an AI Smart Scheduler ranks caregivers for open shifts, Care Insights scores care notes, and an AI voice bot calls caregivers to confirm shifts and updates the schedule. It claims 45+ state EVV integrations, SOC 2 and HIPAA compliance, and 1,000+ agency clients. The trade-off is per-client pricing that rises with your census. It fits a 50 to 200 caregiver agency with Medicaid complexity better than a ten-caregiver startup.

WellSky Personal Care (formerly ClearCare)

WellSky Personal Care is the private-duty product inside WellSky, whose site spans home health, hospice, infusion and payer analytics. The personal care page lists scheduling and visit documentation, analytics and marketing tools, applicant tracking and caregiver training, a mobile app, and the Family Room portal where families see the care calendar and shift notes and can pay or split the bill.

Scale is the argument: 4,000+ agencies transitioned, including 8 of the 10 largest enterprises, and HITRUST CSF certification. SkySense AI covers summarization, ambient documentation and hospitalization-risk prediction. On September 1, 2026 WellSky announced a WelcomeHome partnership to convert inquiries into scheduled care. There is no pricing page. It is the safe enterprise choice and the one your franchisor may require; an agency under 50 caregivers should expect enterprise-style onboarding.

AlayaCare

AlayaCare calls itself "the intelligent operating system for home care" and names its audience: mid-market to enterprise agencies in one or more states, across personal care, private duty nursing, Medicaid HCBS, VA and pediatrics. The platform covers intake, scheduling, workforce management, payroll, EVV, revenue cycle management, care plans, a caregiver app, a family portal and audit trails.

Its AI is agent-shaped. AlayaFlow ships intake, scheduling, clinical and billing agents, plus Layla, a conversational assistant over client and visit data. The site cites 770+ global clients and $250M in R&D. The pricing page lists three tiers with a feature matrix and no prices. If you run 100+ caregivers across state lines, AlayaCare belongs on the shortlist. It is not designed for a five-caregiver agency and does not pretend to be.

Alora Home Care

Alora has been in business 21 years and sells one platform across skilled home health, non-medical home care, hospice and pediatrics. If you run personal care next to a certified home health line, Alora handles both under one login with multi-office support. The home care module covers scheduling, GPS and telephony EVV, live visit monitoring with no-show alerts, visit notes driven by the plan of care, all-payer billing, payroll and reporting.

Alora sells on service and price rather than AI: support answered by an expert on the first ring, bilingual English and Spanish support, offline mobile documentation, and a homepage line that it "costs less than competitors". Its AI is described as a first wave. Pricing depends on users or patients and is quoted by email or phone. For a non-medical-only agency some clinical depth is unused weight; for a mixed agency it is one of the few systems built for exactly that.

ShiftCare

ShiftCare is the other vendor with prices on the page. US plans are Essentials at $9 per user per month, Growth at $15 and Intelligence at $25 ($8, $13 and $20 billed yearly), with a five-user minimum and a custom enterprise tier. "User" means admins plus caregivers, so a 40-caregiver agency on Growth is roughly $600 a month. There is a 7-day free trial with no credit card.

Essentials includes scheduling, a caregiver app with offline mode, GPS clock in and out, Medicaid EVV through Sandata, payroll integrations and AI note transcription. Growth adds bulk invoicing, shift profitability, smart caregiver matching and a job board for vacant shifts. Intelligence adds care plans, eMAR, incident management and a family portal. ShiftCare started in Australia and its US site targets IDD, HCBS and non-medical home care. Per-user pricing works against large part-time rosters, and there is no CRM or inbound phone handling.

Caretime

Caretime is included because buyers still search for it, but caretime.us now reads "Caretime Is Now Alora Health". New sales go through Alora, while existing customers keep their login, data, subscription terms and support team with no forced migration. Historically Caretime served Medicaid agencies, private duty, consumer-directed programs and caregiver registries with scheduling, EVV, revenue cycle services and background screening.

If you are shopping today, evaluate Alora instead. If you are an existing customer, it is a reasonable moment to ask how long the separate platform will be maintained.

HHAeXchange

HHAeXchange is less a competitor to the others than a layer many of them plug into. It connects providers, payers and caregivers, and cites 32,000+ US providers, 180+ managed care organizations and 30 state Medicaid programs. In several states it operates the state-sponsored EVV portal, so Medicaid agencies there use it whether they picked it or not.

The provider product covers scheduling aligned to authorizations, caregiver matching, case broadcasting to fill open shifts by text or the HHAeXchange+ app, billing and claims, private pay, the new CarePay payroll product and outsourced RCM. There is no pricing page. If most of your revenue is Medicaid in an HHAeXchange state, start here. If you are private pay, it is the wrong shape: built around authorizations and payer compliance, not intake, marketing or family billing.

Hailo

Hailo is our product, so weigh this section accordingly. It is the newest and smallest company on this list, without the decade of Medicaid billing history that AxisCare, WellSky or HHAeXchange carry. What it does differently is treat the front office as software: an AI office manager answers your HIPAA-compliant number 24 hours a day, captures intake, books consultations, screens applicants and hands anything consequential to a human for approval.

Pricing is published. Free is $0 with a CRM for 25 active leads a month, a public apply link and marketplace access. Core is $99 a month plus usage and adds the AI office manager, outbound emails and texts and full recruiting, built to run in front of whatever scheduler you already use. Operations is $199 a month plus usage and adds scheduling with automatic shift fill, GPS clock in and out with EVV and offline clock-in, caregiver and family apps, billing, payroll export and reporting, with unlimited clients and caregivers. Voice is $0.10 per minute, texts $0.02, no contract.

The lead marketplace is the other unusual piece: families searching on hailocare.com become exclusive leads matched to one agency, priced per lead, on every plan. Where Hailo is weaker: no aggregator-by-aggregator EVV map, no managed Medicaid billing, and a small reference base. An independent agency can start on Free alongside its current tools, put the AI on the phones for $99, and decide about scheduling later.

Our recommendation by agency size

Startup to 15 caregivers, mostly private pay

Your constraints are cash and the phone. Shortlist ShiftCare and Hailo, the two with published prices and a free trial or free tier, and run both for a week. If you already have a scheduler you like, Hailo Core alongside it is $99 plus call minutes. If you need scheduling and EVV first and can live without a CRM, ShiftCare Essentials at $9 per user is hard to beat.

15 to 60 caregivers, mixed private pay and Medicaid

This is where the incumbents earn their price. Get quotes from CareSmartz360 and AxisCare with the per-client formula at your census and at double. Add Hailo Operations at $199, since flat pricing with unlimited clients changes the math as you grow, while being clear-eyed that its EVV aggregator coverage is newer. If you also run skilled home health, quote Alora.

60 to 200 caregivers, multi-office or multi-state

Shortlist AlayaCare, WellSky Personal Care and CareSmartz360. All three are built for governance across locations and will run an enterprise-style implementation. If most revenue is Medicaid in an HHAeXchange state, HHAeXchange is the system of record and the question is what you layer on top for private pay and intake.

Any size, if unanswered calls are the biggest leak

None of the incumbents lists an inbound AI receptionist for client calls on its site today. CareSmartz360 has an outbound bot for caregiver confirmations and WellSky just partnered with WelcomeHome for inquiry conversion. If missed calls are your biggest leak, Hailo Core is the only option here that addresses it directly, and it runs alongside every other platform on this page.

Frequently asked questions

How much does home care agency software cost in 2026?

Only ShiftCare and Hailo publish prices: ShiftCare is $9 to $25 per user per month with a five-user minimum, and Hailo is $0, $99 or $199 per month flat plus usage. Everyone else quotes on request, usually per active client (CareSmartz360, AxisCare) or per user or patient (Alora).

Which home care software has the best EVV?

Every platform here does GPS or telephony EVV; the differences are aggregator coverage and offline behavior. CareSmartz360 claims 45+ state integrations, HHAeXchange runs the state portal in several states, ShiftCare submits through Sandata. Ask which aggregator is live in your state today.

Is Caretime still available?

Not for new customers. As of September 2026, caretime.us states that Caretime is now Alora Health: new sales go through Alora, while existing customers keep their software, data and terms.

Do I need an all-in-one platform, or can I combine tools?

Small agencies often do better pairing a scheduler they know with a separate front-office layer; Hailo Core is built to run in front of AxisCare, CareSmartz360 or another scheduler. Larger Medicaid agencies usually want scheduling, EVV and claims in one system.

Which platform is best for a franchise agency?

Check your franchise agreement first; many brands mandate a platform. AxisCare, CareSmartz360 (with a franchisor tier) and WellSky Personal Care all market to franchise networks, and ShiftCare and Hailo offer custom enterprise tiers.

Does any home care software answer the phone for me?

Based on the vendor sites reviewed, Hailo is the only one listing an inbound AI office manager that answers client calls 24/7 and captures intake, from its $99 Core plan. CareSmartz360 offers an outbound voice bot that calls caregivers to confirm shifts.