Summary of our market study

In France, the market for medicalized home assistance is estimated at 4.8 billion euros in 2022

The global medical homecare market has experienced significant growth, valued at $362.1 billion in 2022, with forecasts for continued growth at a CAGR of 7.96% between 2023 and 2030, potentially reaching $668.2 billion.

This expansion is driven by an ageing population, the increasing prevalence of chronic diseases and the demand for cost-effective homecare solutions from public authorities.

In France, the medicalized homecare sector has almost doubled in value, reaching 4.8 billion euros in 2022, despite a slowdown in growth due to the COVID-19 pandemic. Technological advances such as connected objects and telemedicine are further driving the development of this market segment.

Market players include public and private entities, as well as non-profit organizations, with growing participation from the private sector. Public initiatives are also seeking to support this sector with financial incentives and regulatory frameworks aimed at improving the integration and efficiency of homecare services.

Trends and growth prospects for home medical assistance in France

Home medical assistance in France is booming, mainly due to the aging of the population and the increasing prevalence of chronic illnesses. Part of the wider homecare sector, this market is particularly focused on medical, social and health care, and aims to meet the needs of the elderly, disabled and chronically ill.

Demand for home medical assistance is fueled by societal trends and political measures that encourage home care rather than institutionalization.

France has seen a marked increase in the number of people aged over 65, a trend that is set to intensify in the years ahead. The elderly population represented only around 9% of the French population in 2022, but projections suggest that this figure could almost double to around 16% by 2052. This increase is becoming palpable as the number of people benefiting from the Allocation personnalisée d'autonomie (APA), an aid for dependent people, has more than doubled since the early 2020s. The financial burden of dependency care on public finances has exploded, topping the 60 billion euro mark, and costs are set to rise further if alternatives to costly institutional care are not strengthened.

Sales of home medical aid have risen from around 2.5 billion euros to just under 5 billion euros in the space of six years, a clear sign of the market's strong growth. This growing demand for home medical assistance is matched by an increase in the number of people accompanying disabled relatives, with millions of French people doing so. The market is also seeing an increase in the number of people suffering from chronic illnesses and long-term health problems, particularly among the poor and elderly, pointing to a growing need for medical assistance aimed directly at people in their own homes.

Digitization is reshaping the market, with connected home devices and telemedicine becoming essential aspects of modern home medical assistance. A significant proportion of the French population believes that connected objects have considerable potential to improve the quality of home care for the elderly, whether in terms of monitoring treatment or improving day-to-day health care. Faced with this burgeoning demand, the landscape of service providers is diverse, ranging from public sector entities such as Centres Communaux d'Action Sociale and Centres Intercommunaux d'Action Sociale, to private associations and a growing number of commercial entities. Many of these organizations meet a variety of needs by offering medical and social assistance in the home.

Key players in the homecare market

The homecare market is a dynamic and vital sector, providing essential services to people who need medical assistance in the comfort of their own homes. This market has seen the participation of both public and private entities, each carving out their own niche while contributing to the overall growth of the industry. Here, we highlight the key players shaping the homecare landscape.

  • public-sector entities: the pioneers of homecare Public-sector entities such as Centres Communaux d'Action Sociale (CCAS) and Centres Intercommunaux d'Action Sociale (CIAS) are the standard-bearers of local authority involvement in homecare. These organizations work closely with local institutions to provide tailored, community-specific assistance to those in need. This involves coordination with national health and welfare organizations to ensure comprehensive, accessible services for their clients.
  • Non-profit associations: the backbone of community care Associations such as ADMR (Aide à domicile en milieu rural) and UNA (Union Nationale de l'Aide, des Soins et des Services aux Domiciles) are at the heart of the medico-social services sector. These private, not-for-profit groups are driven by the values of social entrepreneurship and solidarity. ADMR, for example, focuses on areas such as autonomy and family health, with a presence in rural areas, while UNA is France's leading network for home help, care and services. Their collective commitment to compassion makes them cornerstones of the sector.
  • Private for-profit players: Innovators and expanding entities The growing influence of commercial entities cannot be overlooked in today's homecare market. Although they are not in the majority, companies such as DomusVi, Orkyn, Elivie, Asten, Zephyr Group and Libheros are making significant progress in expanding their services and the scope of their operations. They are leveraging advances in technology and adapting to regulatory changes to present a more diverse range of services, often integrating modern solutions such as telemedicine and therapeutic education into their offerings.
  • Large groups: Champions of scale and scope Finally, the sector has seen the emergence and growth of major groups operating on a larger scale. Korian, for example, specializes in care for the elderly, while La Poste, traditionally a postal service, has turned the corner by entering the homecare market. This diversification means that traditional companies are recognizing the potential and importance of home medical services, leading to innovative product offers and potentially increased demand
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Summary and extracts

1 Market overview

1.1 Market overview and definition

The home medical aid market is a sub-segment of the general home assistance market, which is a form of personal service.

Home medical assistance comprises several types of care provided in the person's own home:

  • Medical and social care: nursing, technical nursing care, etc. These are referred to as SSIAD (Services de soins infirmiers à domicile) or SPASAD (Services polyvalents d'aide et de soins à domicile).

  • Health care: everything to do with hospitalization at home.

Home medical assistance is mainly aimed at vulnerable groups, such as the elderly or disabled, who are ultimately losing their independence. But it can also concern people suffering from chronic illnesses or in need of exceptional assistance.

This market is booming, given the measures taken by the public authorities to encourage people to stay at home rather than in private or public facilities: dependency costs the public purse 63.3 billion euros. added to this is the ever-growing desire of vulnerable people and their families to remain at home. [CNSA]

Indeed, sales of medicalized home help in France were valued at2.5 billion euros in 2016 and will reach a value of4.8 billion euros in 2022, having almost doubled (+92%) in 6 years. [Les Echos]

On a global scale, the home medical aid market is also experiencing strong growth. It is valued at $362.1 billion in 2022 , and should continue to grow at a CAGR of 7.96% over the period 2023-2030, reaching$668.2 billion. The market is largely dominated by North America (42.7% market share), butAsia Pacific is expected to experience the most dynamic growth in the years ahead, due to its aging population. [Grand View Research]

All these factors make the home medical aid market a buoyant one, in which a number of players are trying to make their presence felt: players from the associative sector (ADMR, UNA.); public-sector players (EMS in particular); but also a growing number of private-sector players, such as certain leaders in the Ehpad sector who are attempting to become domiciliaries (Orpéa, Korian...).

1.2 The global homecare market

The home health care market is a sub-segment of the world's fast-growing human services market. Indeed, the latter is estimated at $***.* billion in ****, and is expected to grow at aCAGR of *.*% over the period ****-****, reaching $****.* billion [***]. It is dominated byWestern Europe, followed by Asia Pacific.

Personal assistance market size World, ...

1.3 The French homecare market

By ****, sales generated by the personal services sector are estimated at ** billion euros. Homecare accounts for **% of this market, with a value of**.** billion euros. [***]

Sales of medicalized home help, on the other hand, were valued at *.* billion euros in ****, reaching a value of *.* billion euros in ****. Even if the health ...

2 Demand analysis

2.1 The aging of the population: a favorable phenomenon for the development of this market

Home medical assistance concerns many types of people who are dependent on others for their care. The benchmark is the group of people who can be helped to live independently.

The aging population: already a reality...

Proportion of the French population aged ** or over France, ****-****, in % Source: ****

...which will ...

2.2 People with disabilities

Disabled people are the second largest group to benefit from home medical assistance .

In ****, *.* million people claimed to provide regular assistance to a loved one with a disability or loss of autonomy. [***]

According to the CNSA, if we approach the number of people with disabilities, we can count people under ** as ...

2.3 Development of chronic diseases

Visitchronic or long-term illnesses or health problemsdevelop mainly in the oldest age groups, as well as in people with "poor" living conditions.

Thus, on average, in ****, **.*% of non-poor French people in living conditions had chronic or long-lasting illnesses or health problems, compared with **. *% of poor people (***).

What's more, in ****, **.*% of the ...

2.4 A growing preference for home help

Harris Interactive carried out a survey in July **** on a sample of *** French people aged ** and over. It is entitled "Collective structures and individual solutions: perceptions and expectations of seniors and parents in the context of the Covid-** crisis". The study shows that home help is becoming increasingly popular with this ...

2.5 The housing approach supported by public authorities

The demand for home medical assistance is also supported by the public authorities, who want to reduce public spending on dependency care. This is borne out by the Cour des Comptes report to Parliament entitled "Les services de soins à domicile : une offre à développer dans une stratégie territoriorrialisée de ...

3 Market structure

3.1 The forces at work

The market for medical assistance for the frail is mainly shared between public and private not-for-profit players. However, private players are beginning to step up their presence.

Players in the medical-social services sector

Public-sector players are highly localized and include the Centres Communaux d'Action Sociale (***).

Associations are also extremely active in ...

3.2 Competition from nursing homes and other healthcare establishments

EHPADs are in direct competition with the home

The homecare market is in direct competition with retirement homes (***) in France when it comes to the elderly and dependent population.

EHPADs have been affected by the health crisis and the various revelations that have plagued the Orpéa group in particular, pointing ...

4 Offer analysis

4.1 Types of assistance available at home

Medical and social assistance at home:

Medical assistance at home is a complement or alternative to traditional hospitalization.

It offers people who need it all the services they need to follow their treatment at home, in the comfort of their own home. Of course, this care coordination is organized on the ...

4.2 Coverage of various home medical aids

Calculations for private practice nurses :

Source: ****

Coverage of home care by the Assurance Maladie :

Soure : Libheros

HAH prices

Hospitalisation at home is covered by the Assurance maladie:

**%, as for any hospitalization ; ***% in the case of a situation giving entitlement to full coverage (***).

The complementary health insurance may reimburse the difference ...

4.3 New forms of home medical assistance driven by digitalization

Connected help at home thanks to connected objects is booming

According to Odoxa, **% of French people believe that connected objects, the Internet and its applications could help improve "help and maintenance" for the elderly at home. What's more, according toBVA's "Les Français et les objets connectés" (***) survey, connected objects ...

5 Regulations

5.1 Current regulations

Definition of home medical aid services

Decree no. ****-*** of April **, **** relating to the national specifications for home help and support services and amending the Code de l'action sociale et des familles.

Home nursing care services (***) provide care services in the home or in non-medicalized establishments for the elderly and disabled ...

5.2 SAAD, SSIAD and SPASAD: setting minimum tariffs for new SADs

Decree no. ****-**** of December **, **** relating to the minimum rate applicable to hours of home assistance and to the allocation to guarantee the integrated operation of assistance and care within a home autonomy service (***).

Theorder of December **, **** relating to the minimum tariff mentioned in I of article L. ***-*-* of ...

6 Positioning the players

6.1 Market segmentation

  • AD Seniors
  • ADHAP Services
  • Senior Compagnie (Groupe Zephyr)
  • Aquarelle Service
  • Age d’Or Services
  • Petit-Fils (Korian Groupe)
  • Solutia Groupe
  • Oui Care
  • Domidom
  • Adomis (Zephyr groupe)
  • Adenior
  • ADMR
  • UNA
  • DomusVi
  • Orkyn (Air liquide)
  • Homeperf
  • Korian Clariane
  • Bestens umsorgt (KORIAN Group)
  • Zephyr Groupe
  • Elivie (Groupe Santé Cie)
  • Asten Santé (La Poste)
  • La Poste
  • Air Liquide Santé

List of charts presented in this market study

  • Personal services market value
  • Size of the global homecare market
  • Number of APA (Allocation Personnalisée d'Autonomie) beneficiaries
  • Population projections to 2070
  • Proportion of French population aged 65 and over
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Latest news

Philippe Wahl: "La Poste, multi-functional" | Philippe Wahl: "La Poste, multi-functional" - 04/12/2023
  • The number of letters sent in 2023 will be six billion, compared with 18 billion fifteen years ago.
  • La Poste employs some 240,000 people, including 65,000 letter carriers.
  • La Poste's plan calls for the delivery of five million meals by 2023, in over 200 towns and cities.
  • la Poste, which specializes in parcels in France and abroad, accounts for 52% of La Poste group's sales
  • La Poste develops a digital safe service with Docaposte.
Ehpad: Clariane (ex-Korian) refinances to avoid defaulting on payments - 14/11/2023
  • Clariane refinancing plan: 1.5 billion euros Real estate partnership with Crédit Agricole Assurances (CAA) for : 140 million euros
  • Negotiations for a second real estate partnership concerning assets in the United Kingdom: 90 million euros
  • Asset disposal program planned for the following year: around 1 billion euros
  • Proposed capital increase to raise: 300 million euros
  • Fall in Clariane share price between October 24 and 26: 35.9%
  • Capital increase announced by competitor Orpea: approx. 3.9 billion euros.
Ehpad: ex-Korian in dire straits - 14/11/2023
  • Clariane (ex-Korian) is number one in France in the Ehpad sector
  • The company has announced a €1.5 billion refinancing plan to avoid defaulting on its debts
  • Sales up 9.0% in the first nine months of the year
  • Clariane's Ehpad occupancy rate is 88.9%
  • Clariane carries 1.6 billion euros of debt to be refinanced in 2023-2024
  • The company's plan calls for 1 billion euros in asset disposals
  • The company is considering a capital increase of 300 million euros, 200 million of which will be guaranteed by Crédit Agricole Assurances, Clariane's largest shareholder (24.8%)
La Poste enters the world of healthcare - 19/10/2023
  • La Poste has a network of 35,600 access points in France.
  • Since 2017, La Poste has begun to diversify into the healthcare sector, acquiring several healthcare companies
  • Currently, La Poste accompanies 140,000 patients at home on medical prescription.
  • Nearly one million meals delivered to homes in one year.
  • 30 million hospital admissions are managed each year using its administrative management software (Maincare).
  • More than 300,000 teleconsultations have been carried out thanks to La Poste.
  • La Poste has a digital cloud solution (NumSpot) "made in France".
  • La Poste forecasts healthcare sales of 500 million euros by 2030, compared with 300 million today.
  • La Poste has developed an AI solution for healthcare through its NumSpot subsidiary.
Air Liquide to cut 430 jobs in its Homecare business - 06/07/2023
  • Air Liquide plans to restructure its Homecare business in France
  • 430 job cuts planned, i.e. around 7% of the French healthcare workforce (6,000 people)
  • This activity includes the supply of medical gases, breathing apparatus and masks
  • This transformation project includes the reorganization of one of the Group's main homecare entities, Pharma Dom, the simplification of the brand portfolio, and the regrouping of certain sites
Senior residences: Casa Barbara welcomes Atream reinforcement - 03/07/2023
  • Casa Barbara is a young brand of serviced residences for active seniors, launched at the end of 2021 by Clariane.
  • Two Casa Barbara units already exist, one in Nice and the other in Levallois-Perret (Hauts-de-Seine), due to open in 2022.
  • A partnership has been set up with real estate investment company Atream to open a further 15 residences by 2030.
  • Atream will commit 250 million euros over seven years to the construction of these units.
  • These new units will be owned by a real estate company and operated by a joint venture jointly owned by Clariane, the Triganos and Atream, with each partner holding one-third of the capital.
  • Atream plans to invest 220 million euros in the first 15 units of the new budget hotel chain Oh Baby, in which Serge and Jérémie Trigano are also involved.
  • Atream is also one of the investors involved in the rescue and relaunch of Groupe Pierre & Vacances Center Parcs.

Companies quoted in this study

This study contains a complete overview of the companies in the market, with the latest figures and news for each company. :

AD Seniors
ADHAP Services
Senior Compagnie (Groupe Zephyr)
Aquarelle Service
Age d’Or Services
Petit-Fils (Korian Groupe)
Solutia Groupe
Oui Care
Domidom
Adomis (Zephyr groupe)
Adenior
ADMR

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