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Home Care Franchisors Overcame Obstacles to International Expansion


A number of U.S. home care franchisors have successfully exported their franchise concept to other countries despite the differences among health care systems.

While in the process of completing a soon to be published report entitled A Report on the State of the Franchised Home Care Sector 2013. I found one of the more revealing statistics is the number of U.S. home care franchisors with international operations. Given the unique aspects of the U.S. health care system compared to other countries itís interesting to see how many home care franchisors have successfully gone international. Of the top seventeen home care franchisors with 100 hundred locations or more:

  • Four franchisors are in multiple countries ranging from five to fifteen
  • Six are in Canada
  • Of the remaining seven, four are actively seeking international licensees


A number of years ago, when the franchised home care sector was in its infancy one of my responsibilities as senior VP was to export our home healthcare franchise to other countries. We were able to license our franchise in several countries including transacting the first U.S. home care franchise in Japan. Although we provided a full range of skilled nursing services, it became apparent that given the health care reimbursement systems in other countries ("Socialized Medicine") the best market opportunity was for non-skilled private pay services. Nevertheless, franchising home care in other countries was a real challenge.

There are a number of lessons we can learn from the success of todayís home care franchisors going international. These lessons can be applied to other franchise concepts.

  1. Determine if there is a market for the franchise products or services by utilizing a knowledgeable advisor thoroughly familiar with the target country. If possible try to find someone located in the target country.
  2. Target a manageable foreign market at the beginning. A number of franchisors go to Canada or a small country in Central America first.
  3. Consider unit franchises in the small country. The franchisees can be serviced from the U.S. corporate base.
  4. Be flexible and willing to adapt the franchise program to meet differences in the foreign country. There may be certain attributes of the franchise operation that if properly tweaked would be successful in another country.
  5. Target a limited number of specific countries that most closely match the market characteristics and demographics you are looking for. I can recall franchising in Indonesia which today still lacks many of the attributes necessary for a successful franchise concept.
  6. Be willing to invest some time and money in order to visit and become familiar with the target countries.

A number of U.S. home care franchisors have been able to successfully franchise their concept in other countries. Despite the differences that exist between health care systems in the U. S. and other countries these franchisors were able to execute a successful strategy for going international. Finally, as a reminder, be sure that the key components of an international development program are in place before executing the franchise documents.


© 2013 FranchiseKnowHow, LLC

Ed Teixeira is the President of FranchiseKnowHow, LLC. He can be reached at franchiseknowhow@gmail.com

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2015 home care franchise industry report



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