PEOs that serve long-term health care workers

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PEOs And Home Healthcare Organizations

ADP TotalSource, FrankCrum, Adams Keegan, the LBMC Family of Companies, AmiHR, and Resourcing Edge are six examples of the largest professional employer organizations (PEOs) that offer their services to home health care organizations.


  • ADP is the company with the largest share of the PEO market in the United States. In 2017, when the market recorded a total revenue of $170.411 billion, its market share was 23.10%. This means that ADP's PEO revenue in 2017 was an estimated $39.365 billion.
  • ADP serves the following industries: restaurant/hospitality, manufacturing, professional and technical services, construction, financial services, retail, health care, government/education, and non-profit/social services. ADP says it can help health care organizations regardless of whether they are a physician's office, an extended care facility, a home health service provider, or a medical/surgical hospital.
  • ADP offers payroll and human resource solutions, including solutions that help track licenses, training, and certifications, assist staffing managers in scheduling, and help distribute content to keep employees abreast of policies and laws. Solutions encompass payroll, time and attendance, talent, benefits, human resource services, and outsourcing options.
  • ADP's PEO solution is called ADP TotalSource®. The solution offers the services of a full-service human resource department, along with access to "Fortune 500®-caliber benefits."
  • ADP TotalSource is a member of the National Association of Professional Employer Organizations (NAPEO) since January 1991.


  • FrankCrum has a revenue of around $50 million.
  • Construction, home health care, and hospitality are some industries FrankCrum serves.
  • FrankCrum offers services relating to payroll and tax administration, worker's compensation, employee benefits, human resource support, human resource information system, risk management and compliance, commercial insurance, and staffing.
  • FrankCrum is a NAPEO member since November 1991.


  • Adams Keegan has a revenue of around $13.7 million.
  • Hotels, restaurants, and senior care are just some industries Adams Keegan serves. Adams Keegan says it has a firm grasp of the needs of health, senior, hospice, and home care providers.
  • Adams Keegan offers services relating to payroll, reporting, onboarding, employee records, management of E-Verify, work opportunity tax credit (WOTC), and EEO-1 reports, compliance, human resource information system (HRIS), and industry recruiting.
  • Adams Keegan is a NAPEO member since August 2004.


  • The revenue of the LBMC Family of Companies is an estimated $9.5 million.
  • The LBMC Family of Companies serves the following industries: healthcare, individuals, insurance, professional services, manufacturing and distribution, private equity, technology, retail, restaurants, hospitality, franchises, real estate, construction, and others. In the health care industry, it has experience in the following segments: ambulatory surgical centers, behavioral health, continuing care retirement communities, durable medical equipment, health plans, health care information technology, and home health.
  • The company offers solutions relating to audit and assurance, health care valuation solutions, health care consulting, human resource services, information security, management services, recruiting and staffing, tax, technology, and transaction advisory services.
  • The company is a NAPEO member since June 1999.


  • AmiHR's revenue is estimated at $7.8 million.
  • It has experience in the following industries: hospitality, environmental engineering, information technology, construction, legal, gaming, home health, health, social services, and hospice.
  • Its services include training, recruitment, compliance, performance management, compensation, time off, termination, claim administration, onboarding, safety management, payroll, benefit administration, among others.
  • AmiHR is not a NAPEO member, but it describes itself as a PEO, an administrative services organization (ASO), and a human resources outsourcing organization (HRO).


  • The revenue of Resourcing Edge is an estimated $7.5 million.
  • Resourcing Edge serves the following industries: automotive, construction, manufacturing, professional and business services, home repairs, health care, leisure and hospitality, oil and gas, retail, and technology. In the health care industry, it serves the following sub-industries: assisted living, emergency or urgent care, health care practitioners, home health, and general health care.
  • Resourcing Edge offers services relating to payroll and tax administration, benefits administration and consultation, risk management and compliance, time and attendance, human resource services, and technology. The company differentiates itself from other PEOs through its customized solutions, advanced technology, and specialists. It boasts of a single point of contact.
  • Resourcing Edge is a NAPEO member since June 2012.


We began with a search for rankings of PEOs in the United States. This led us to statistics indicating that the largest players in the United States PEO industry are ADP TotalSource, TriNet, and Insperity, whose shares of the market in 2017 were 23.10%, 18.70%, and 10.10%, respectively. They are followed by Paychex, BBSI, Oasis, and CoAdvantage in no particular order. Five of these PEOs, namely, ADP TotalSource, Paychex, Insperity, TriNet, and BBSI, are publicly traded. As these were mentioned as the biggest and most prominent PEOs in the United States, we started with these companies. We scoured the websites of these seven companies and Justworks and found that only ADP explicitly states on its website that it serves home health care organizations. There is no indication on the websites of TriNet, Insperity, Paychex, BBSI, Oasis, CoAdvantage, and Justworks that they provide services to home health care organizations or have experience in the home health care industry. It is worth noting, however, that Coadvantage's chief information officer, Mark Zimmerman, was formerly the area vice president of information technology of CareCentrix, the country's biggest home health care organization. Also, Insperity serves the health care industry but does not indicate whether it serves home health care providers.

We proceeded to find other PEOs that serve home health care providers but had difficulty locating them. Most PEOs do not list the industries they serve, news coverage is nil, and the existence of PEO brokers added to the confusion. After finding just two valid companies, Resourcing Edge and AmiHR, after numerous search attempts, we decided to change tactics. We looked for lists, databases, or directories of PEOs in the United States and came across the National Association of Professional Employer Organizations (NAPEO), the association representing PEOs in the United States. Fortunately, NAPEO has a member directory by state that we found very useful, as 300 of the 907 PEOs in the country are members of the association. We could not check all states, so we randomly picked three states, New York, California, and Texas, and checked the PEOs listed under these states one by one. After opening over 200 website links, we found only three more PEOs that serve home health care organizations, namely, FrankCrum, Adams Keegan, and the LBMC Family of Companies. In finding the revenues of FrankCrum, Adams Keegan, the LBMC Family of Companies, and AmiHR, which are all privately held, we referred to business information sites ZoomInfo, Crunchbase, Hoovers, Glassdoor, and Owler (in case no other credible source could be found). We then ranked the companies based on revenue. It appears from an examination of the websites of these companies that these companies' PEO services are limited to the United States.


  • "According to IBISWorld, 52% of the industry’s gross revenue is controlled by the top 3 players; ADP Totalsource, TriNet and Insperity with the remaining 48% controlled by the rest of the field. The PEO industry is more top heavy than the report illustrates. Once you factor in Oasis, Paychex, CoAdvantage and BBSI the numbers are more heavily skewed toward the largest handful of PEOs controlling a large majority of industry revenues. "
  • "There are currently five large publicly traded PEOs; ADP TotalSource, Paychex, Insperity, TriNet, and BBSI. "
  • "There are 907 PEOs in the United States."