Best Cities in Georgia to Start a Home Care Agency in 2026
Team Carepolicy.usGeorgia is one of the fastest-aging states in the South. By 2030, more than 20% of Georgia’s residents will be over 60, with many choosing to age at home instead of in nursing facilities. This makes the home care industry one of the most promising healthcare business opportunities in the state.
But like any business, location matters. Some parts of Georgia, like metro Atlanta, are crowded with agencies, while others have thousands of seniors with only a few providers.
This article breaks down the numbers, gives you county-by-county insights, and shows where the real growth opportunities lie in Georgia’s home care market.
Get help before you file: Book a licensing consultation to map your county choice, PHCP licensure steps, and payer strategy. For operations, see the Non-Medical Home Care Agency Policies & Procedures (Any State) and the Home Care Agency Operational Form Pack.
Why Georgia’s Home Care Market Is Growing
- Rapid Senior Growth – Atlanta suburbs, North Georgia, and coastal areas are seeing the fastest increase in older adults.
- Rural Aging – Many rural counties have higher percentages of seniors than urban areas, but far fewer licensed providers.
- Private Pay vs. Medicaid – Wealthier metro counties support premium services, while rural counties depend more on Medicaid waiver programs.
- Migration Trends – Retirees from northern states are moving into Georgia (especially Savannah, Augusta, and North Georgia mountain towns).
Tip: If you plan to credential for Georgia waivers, review CCSP and SOURCE under the Elderly & Disabled Waiver Program. Start with Georgia Medicaid’s overview of waiver programs (CCSP & SOURCE) and the state portal for Medicaid waiver applications.
Table: Seniors vs. Agencies by Georgia Counties / Cities
Here’s a simplified Saturation Index view = (Agencies ÷ Seniors 65+) × 10,000. Lower index = less competition (better opportunity).
| County / City | Estimated Agencies | % Seniors (65+) | Total Population | Seniors (65+) | Saturation Index | Market Insight |
|---|---|---|---|---|---|---|
| Forsyth County (North Metro ATL) | 55 | 14.7% | 267,000 | 39,249 | 14.0 | Wealthy, growing fast, room for private-pay expansion. |
| Cobb County (Atlanta Suburbs) | 160 | 15.5% | 781,000 | 120,055 | 13.3 | Large senior base, still moderate saturation. |
| Gwinnett County | 180 | 12.8% | 975,000 | 124,800 | 14.4 | Diverse, high growth, demand for bilingual caregivers. |
| Fulton County (Atlanta City) | 300+ | 13.0% | 1,070,000 | 139,100 | 21.6 | Very competitive – succeed only with niche services. |
| DeKalb County | 190 | 13.6% | 765,000 | 104,040 | 18.3 | Competitive but demand is strong; urban-focused agencies thrive. |
| Chatham County (Savannah) | 70 | 17.1% | 308,000 | 52,668 | 13.3 | Popular retirement destination, strong demand. |
| Richmond County (Augusta) | 65 | 17.5% | 205,000 | 35,875 | 18.1 | Senior-heavy, but more competition than nearby rural counties. |
| Macon-Bibb County | 60 | 18.5% | 157,000 | 29,045 | 20.7 | High senior ratio but also dense provider presence. |
| Hall County (Gainesville area) | 30 | 16.2% | 216,000 | 35,000 | 8.6 | Low saturation, strong demand – hidden gem in North Georgia. |
| Lowndes County (Valdosta) | 18 | 15.9% | 121,000 | 19,240 | 9.3 | Underserved South Georgia hub – strong Medicaid/waiver opportunity. |
| Columbia County (Augusta Suburb) | 25 | 15.4% | 164,000 | 25,256 | 9.9 | Suburban retirement growth, low competition. |
| Glynn County (Brunswick / Coastal GA) | 22 | 22.0% | 85,000 | 18,700 | 11.8 | High senior ratio, retirement destination, good private-pay market. |
Planning toolkit: Draft your financials with the Home Care Business Plan template and prepare staff onboarding with the Home Care Employee Handbook.
Key Takeaways
Best Opportunities (Low Index, High Demand)
- Hall County (Gainesville area): Strong senior population, relatively few providers – one of the best hidden opportunities.
- Forsyth & Cobb Counties: Wealthy, growing suburbs with strong demand for premium and private-pay services.
- Columbia County (Augusta suburb): Growing retiree population, low competition.
- Lowndes County (Valdosta): Underserved regional hub in South Georgia, strong Medicaid waiver opportunities.
Moderate Opportunities (Need Differentiation)
- Gwinnett County: Diverse population, high demand, but agencies must offer bilingual and culturally competent care.
- Chatham County (Savannah): Retirement hotspot with demand for Alzheimer’s and respite care.
Saturated Markets
- Fulton (Atlanta), DeKalb, Richmond, and Macon-Bibb Counties: Strong demand but already crowded. Agencies must specialize (memory care, transitional care, veteran programs) or target niche groups to survive.
Insights for Providers and Investors
- Suburban Growth Is Key: Atlanta suburbs (Forsyth, Cobb, Gwinnett) are growing rapidly and will sustain long-term demand.
- Rural Counties Are Underserved: Places like Lowndes and Hall have strong senior populations but far fewer agencies. Logistics are harder, but margins may be better with Medicaid/waiver services.
- Coastal & Retirement Markets: Savannah (Chatham) and Brunswick (Glynn) are prime for private-pay retirees, especially with dementia care services.
- Atlanta Metro = Niche Only: Fulton and DeKalb have too many agencies. Only enter if you bring something unique—specialty Alzheimer’s care, tech-driven monitoring, or cultural/linguistic services.
Georgia licensure shortcut: Review the state’s Private Home Care Provider (PHCP) licensing overview and the current PHCP application packet. If you need done-for-you documentation, use our Policies & Procedures manual and List of All Forms.
Next step: Book a licensing consultation to align county selection, payer mix (private pay vs. waivers), and launch timeline.
Final Word
If you’re planning to open a home care agency in Georgia in 2026, the best counties are Hall, Forsyth, Cobb, Columbia, and Lowndes. These areas combine strong senior demand, manageable competition, and steady growth potential.
Urban hubs like Fulton, DeKalb, and Richmond remain important but require sharper positioning and niche services to stand out.
For nurses, doctors, or business investors, Georgia’s demographics and migration trends make home care one of the strongest growth opportunities in the South. The only real question is: will you choose a saturated metro or an underserved county ready for your services?
Resources for Georgia Licensing and Payers
- Georgia Healthcare Facility Regulation Division (HFR) – Facility licensure authority for PHCPs.
- Private Home Care Provider program overview – Who needs a license and key requirements.
- Licensure Forms & Applications (PHCP Packet) – Current application materials.
- Georgia Medicaid Waiver Programs (CCSP & SOURCE) – Waiver services for eligible seniors.
- Apply for Medicaid waivers (state portal) – Centralized application links.
- Georgia DHS: 20% of Georgians will be 60+ by 2030 – Demographic context for planning.
FAQs
Do I need a license to provide non-medical home care in Georgia?
Should I target private pay or Medicaid waivers first?
What documents do I need to launch quickly?