How to Grow Your Home Care Agency in Indiana: 5 Moves That Actually Work

Most agencies try to grow the same way: run more ads, hire another marketer, wait for the phone to ring. In Indiana’s Medicaid-heavy home care market, that’s not where growth actually comes from.

Growth comes down to who you’re credentialed to serve, who you can actually communicate with, and who trusts you enough to send you their patients. Here’s how to move on all of that.

1. Add more waivers to your coverage

If your agency only serves one waiver population, you’re turning away referrals every week without realizing it. Indiana’s HCBS waiver system splits people by age and diagnosis, and each waiver is a separate door into your agency.

Here’s the current landscape:

PathWays for Aging — for Hoosiers 60 and older. This is managed care, not fee-for-service. Members are enrolled with one of three Managed Care Entities: Anthem, Humana, or UnitedHealthcare.
Health & Wellness (H&W) Waiver — for individuals 59 and younger who meet a nursing facility level of care. This is fee-for-service, administered by the Division of Disability, Aging and Rehabilitative Services (DDARS).
Traumatic Brain Injury (TBI) Waiver — for individuals of any age with a TBI diagnosis, also fee-for-service through DDARS.
CIH and Family Supports Waivers — for children and adults with intellectual or developmental disabilities, managed through the Bureau of Disability Services (BDS).

Getting credentialed isn’t a single step. For PathWays, H&W, and TBI, you need OMPP certification first, then IHCP enrollment, then separate credentialing with each individual MCE you want to bill. Being enrolled in IHCP does not mean you get paid for PathWays members. Only MCE credentialing gets your claims paid, and each MCE runs its own contracting process. Budget at least a few weeks per MCE application before you start seeing approvals.

Where to start: Pull your current clients by waiver type. If you’re PathWays-only, get credentialed with all three MCEs, not just one. Agencies that are only contracted with one PathWays MCE are invisible to referral sources working with the other two.

2. Add more languages to your care team

Referral sources — case managers, MCE care coordinators, discharge planners — run into the same wall constantly: a client needs care, and the agencies they know can’t serve someone who doesn’t speak English well. When your agency can, you become the answer to a problem nobody else in the room can solve.

How to actually do this:

Pull the language data for the counties you serve. Every county has a different mix.
Recruit bilingual caregivers directly. Post in community groups and with cultural organizations, not just job boards.
Translate your intake paperwork and consent forms into your top one or two non-English languages. This is usually the first thing a family notices, and the first thing that builds trust.

You don’t need to cover every language in the state, but being able to serve these clients sets you apart from the agencies that can’t.

3. Get involved in community events and network with the right doctors

Home care referrals are usually relationship-driven, not ad-driven. People often ask the discharge planner, the case manager, or the doctor they already trust for recommendations.

Community events to attend:

Senior expos and health fairs
Area Agency on Aging (AAA) events
Aging and Disability Resource Center (ADRC) events
Faith communities and cultural centers, especially if you’re building out language access at the same time

Showing up once doesn’t move the needle. Showing up consistently, with a real person who remembers names, is what turns a booth into clients six months later.

Not all doctors send the same volume of referrals. Focus your networking where the need is concentrated:

Geriatricians and primary care physicians with older patient panels — steady, ongoing referral source
Neurologists treating dementia, Parkinson’s, or stroke patients — high-need, long-duration care cases
Orthopedic surgeons — post-op recovery care is often short-term but high-volume
Palliative care and hospice physicians — frequent overlap with home care needs

And don’t stop at the physician. In practice, a huge share of post-hospital home care referrals come from discharge planners and hospital case managers, not always the doctor directly. Building a relationship with the discharge planning team at your local hospital system is often more valuable than the doctor’s own referral, because that’s the person actually making the call when a patient is ready to go home.

4. Get into the referral directories and systems people actually search

A lot of the time, referral sources and potential clients open a directory or a software system and pick from whatever’s listed. If your agency isn’t in it, or your listing has the wrong phone number, service area, or waiver types, you’re invisible before a single phone call ever happens.

2-1-1 Indiana and the ADRC/AAA resource directories are the default starting point for a lot of case managers and options counselors doing a first search. Check that your listing exists and is current. Most agencies set this up once, years ago, and never touch it again.
Ask your MCE contacts whether they maintain an internal “find a provider” list or preferred vendor list that care coordinators use. Being contracted with an MCE is not the same as being visible to the care coordinator who’s actually deciding who gets the referral.
If a hospital system in your area uses a discharge-planning or care-coordination platform, ask their case management department how a home care provider gets added to it. Most agencies never ask this question and rely entirely on personal relationships instead, which means they’re only ever as good as whoever happens to remember their name that day.

5. Level up your free marketing

Not every growth lever costs money or takes months to build. Before anything else, make sure your basic online presence is actually working for you, because families and referral sources check it before they ever pick up the phone.

Claim and optimize your Google Business Profile. Keep your hours, service area, and phone number accurate, add real photos, and post updates when something changes. This is often the first thing a family or discharge planner looks at after getting your name from someone else.
Ask for reviews and respond to every one. A steady stream of recent, positive reviews is frequently what tips the decision when a family is choosing between two agencies they were referred to. Responding to every review, including the occasional bad one, shows people someone is actually paying attention.

Both of these are free, take an afternoon to set up, and keep working in the background long after you’ve moved on to the next thing.

The real growth lever

None of this requires a bigger ad budget. It requires expanding who you’re credentialed to serve, who you can communicate with, and who trusts you enough to send you their people. Agencies that stack several of these at once, rather than picking one, are the ones that grow fastest in this market.

Every move in this post takes time, and time is the one thing agency owners never have enough of. GEOH can take billing and scheduling off your plate, so you can actually spend your time on the growth side: getting credentialed with a new MCE, building the referral relationships, showing up at the next community event. If you’re ready to grow and want a partner handling the billing and scheduling behind it, book a demo with GEOH to see how it works.