14 Best Home Care Software Payroll Accounting Integrations [2026 Updated]

Choosing the right software for your home care agency is about more than just scheduling and billing—it's about creating a seamless financial workflow that saves time, reduces errors, and ensures compliance. The connection between your core home care management platform, your payroll system, and your accounting software can make or break your back-office efficiency. This article details the 14 best integrations that home care agencies can rely on in 2026 to connect these critical systems.

Home Care Payroll & HR Integrations

These platforms handle the complexities of caregiver payroll, tax withholding, and HR compliance, connecting a mobile workforce to your financial back office.

1. Gusto

Gusto is a modern, user-friendly payroll and HR platform designed for small to medium-sized businesses. Its strength lies in its automation of payroll, tax filing, and benefits administration. For home care agencies, Gusto simplifies onboarding for a distributed caregiver workforce and integrates directly with top accounting software like QuickBooks and Xero, ensuring that wage and tax data flows directly into your general ledger without manual entry.

• Pros:
  • Extremely easy-to-use interface for both admins and employees (caregivers).
  • Fully automated federal, state, and local tax filings.
  • Offers integrated health benefits, GLBA, and workers' comp administration.
  • Strong direct integrations with QuickBooks Online and Xero.
• Cons:
  • May lack the advanced, customizable reporting needed by very large, multi-state agencies.
  • Pricing can become expensive as the number of employees grows, particularly on higher-tier plans.
• Pricing:
  • Offers a Simple plan starting at approximately $40 per month plus $6 per person.
  • Plus and Premium plans offer advanced HR tools, time tracking, and dedicated support for a higher base fee and per-employee cost.

Who it's best for: Small to mid-sized home care agencies that want an intuitive, all-in-one payroll, benefits, and HR platform with clean accounting integrations.

2. ADP Workforce Now

ADP is an undisputed leader in payroll and HR services, and its Workforce Now platform is built for businesses with complex compliance and scalability needs. For home care agencies operating across multiple states or managing intricate pay rules (like overtime, travel time, and differentials), ADP provides robust calculation and compliance tools. Its "Connector" marketplace allows integration with accounting systems, ERPs, and some home care management platforms.

• Pros:
  • Industry-leading expertise in payroll tax and labor law compliance.
  • Highly scalable architecture suitable for large, growing agencies.
  • Comprehensive HR suite including recruiting, talent management, and analytics.
  • Extensive integration options through the ADP Marketplace.
• Cons:
  • Can be more expensive than other options on this list.
  • The user interface is less modern and can feel complex compared to newer platforms.
  • Implementation and setup can be a lengthy process.
• Pricing:
  • Quote-based pricing tailored to your agency's specific size and module needs.
  • Generally suited for mid-market to enterprise-level clients.

Who it's best for: Large, multi-state home care agencies with complex compliance requirements that need an enterprise-grade, scalable solution.

3. Paychex Flex

Paychex Flex is a versatile payroll and HR solution that scales from small agencies to large enterprises. It stands out for its flexibility, allowing you to choose the level of service you need, from simple payroll processing to a full-service PEO model. It offers dedicated support and strong compliance features relevant to home care, including workers' compensation and wage-and-hour law adherence. Paychex integrates with popular accounting software like QuickBooks, Sage, and Xero.

• Pros:
  • Scalable plans that can grow with your agency.
  • Offers 24/7 support from U.S.-based specialists.
  • Strong mobile app for caregivers to access their pay stubs and tax info.
  • Provides extensive reporting and analytics capabilities.
• Cons:
  • The pricing structure can be complex, with many features offered as add-ons.
  • Some users report that the interface is not as intuitive as newer market entrants.
• Pricing:
  • Paychex Essentials plan starts around $39 per month plus $5 per employee.
  • Custom pricing is required for more advanced plans (Paychex Flex Select and Pro).

Who it's best for: Home care agencies of all sizes looking for a flexible, well-supported payroll provider with strong reporting capabilities.

4. QuickBooks Payroll

For home care agencies already using QuickBooks Online for their accounting, QuickBooks Payroll offers the most tightly integrated experience. Payroll data, including wages, taxes, and reimbursements, automatically populates in the general ledger, eliminating the need for manual journal entries. It handles automated tax payments and filings, and its integrated time tracking can be a good fit for agencies not using a dedicated home care platform.

• Pros:
  • Frictionless integration with QuickBooks Online, syncing data perfectly.
  • Automated payroll and tax filing capabilities are included.
  • Simple, clean interface that feels familiar to current QuickBooks users.
  • Offers multiple tiers to fit different budget and feature needs.
• Cons:
  • Time tracking and HR support are less advanced than dedicated payroll providers like ADP or Gusto.
  • Customer support experiences can be inconsistent.
  • Best value is locked in for those committed to the QuickBooks ecosystem.
• Pricing:
  • Core plan starts with a base fee plus a per-employee monthly charge.
  • Premium and Elite plans add same-day direct deposit, HR support, project tracking, and dedicated expert review.

Who it's best for: Small to medium-sized home care agencies that already run their bookkeeping on QuickBooks Online and value a single-ecosystem solution.

Accounting Software Integrations

These platforms serve as your financial hub, where payroll data meets billing information to create a full picture of your agency's health.

5. QuickBooks Online

QuickBooks Online is the most popular accounting software for small and medium-sized businesses in the US. Its extensive API and app marketplace make it the default integration target for nearly every payroll and home care management platform. It works well for home care agencies by managing invoicing, P&L reporting, expense tracking, and bank reconciliation. It is the central nervous system connecting field operations to financial reporting.

• Pros:
  • Vast third-party app ecosystem for endless customization and integration.
  • Accountants and bookkeepers are widely familiar with the platform.
  • Cloud-based access allows for management from anywhere.
  • Strong financial reporting for tracking agency performance.
• Cons:
  • Monthly subscription can feel costly compared to one-time desktop software purchases.
  • Over-reliance on app integrations can sometimes lead to data sync issues.
• Pricing:
  • Four main tiers: Simple Start, Essentials, Plus, and Advanced.
  • Agencies will likely need the Plus plan or higher to manage accounts payable and track project/location profitability.

Who it's best for: Virtually any home care agency that needs a reliable, universally supported accounting platform to anchor its financial operations.

6. Xero

Xero is a strong, cloud-based alternative to QuickBooks Online, beloved for its clean design and unlimited user policy on all plans. It excels at bank reconciliation and offers a robust, open API that supports deep integrations with payroll solutions like Gusto and platforms via middleware. Its project tracking features can be adapted to manage profitability by client or service line in a home care setting.

• Pros:
  • Beautiful, intuitive user interface that's easy to learn.
  • Unlimited users included in every plan, great for growing teams.
  • Open API fosters a large ecosystem of over 1,000 integrated apps.
  • Strong mobile app for managing finances on the go.
• Cons:
  • Payroll feature is only available through a Gusto integration, adding an extra subscription.
  • Not as dominant in the US market, so fewer accountants specialize in it compared to QuickBooks.
• Pricing:
  • Tiered plans (Early, Growing, Established) based on the volume of invoices, bills, and bank transactions.
  • The Growing plan is the typical starting point for a functional business.

Who it's best for: Tech-savvy home care agencies that appreciate a modern design and need to provide access to multiple team members without per-user fees.

7. Sage Business Cloud Accounting

Sage Business Cloud Accounting is a dependable solution from a legacy accounting software leader. It's well-suited for agencies managing inventory (like medical supplies) alongside their services. Sage offers solid core accounting, invoicing, and bank connection features, and its payroll integration makes an end-to-end financial suite. The platform focuses on accurate cash flow forecasting and management, which is important for agencies navigating inconsistent reimbursement schedules.

• Pros:
  • Strong cash flow management and forecasting tools.
  • Direct integration with Sage Payroll for an all-in-one system.
  • Good inventory management capabilities for agencies that bill for supplies.
• Cons:
  • The number of third-party app integrations is smaller than QuickBooks or Xero.
  • The user interface is functional but feels less modern than its competitors.
• Pricing:
  • Two primary plans: Sage Accounting Start and Sage Accounting.
  • Most agencies will require the more comprehensive Sage Accounting plan for reporting and quoting.

Who it's best for: Growing home care agencies, particularly those with inventory needs, who prefer to rely on a single, long-standing vendor for accounting and payroll.

Home Care Management Platforms with Strong Integrations

These are the industry-specific operating systems that manage the day-to-day of home care. Their ability to integrate with financial software is what completes the workflow.

8. ClearCare (by WellSky)

ClearCare is one of the most widely used home care management platforms, managing everything from scheduling and client management to EVV (Electronic Visit Verification) compliance. It offers pre-built API integrations with major payroll providers, including ADP and Paychex, and a popular connector for moving billing and payroll data directly into QuickBooks. This integration saves countless hours of manual data entry.

• Pros:
  • Market leader with deep functionality specific to home care.
  • Direct integrations with top payroll providers simplify wage calculations.
  • Seamless QuickBooks integration for billing and payroll journal entries.
  • Strong EVV and compliance features built-in.
• Cons:
  • As an enterprise solution, it can be one of the more expensive options.
  • You are limited to the specific payroll partners they directly support for native integrations.
• Pricing:
  • Custom, quote-based pricing depending on agency size and features.

Who it's best for: Agencies of all sizes looking for a powerful, industry-standard platform with proven and reliable payroll and accounting integrations.

9. MatrixCare

MatrixCare provides EMR and billing systems for various out-of-hospital care settings, including home health. The platform is built around clinical documentation and claims processing, making it ideal for certified agencies dealing with Medicare and Medicaid billing. It provides robust options for exporting payroll and billing data and supports integrations with ADP and other payroll processors for end-to-end workflow management.

• Pros:
  • Excellent for clinical documentation and Medicare/Medicaid billing.
  • Offers configurable payroll extracts that can be adapted to many systems.
  • Scalable for large, multi-faceted healthcare organizations.
• Cons:
  • Can be more complex to set up and learn due to its clinical focus.
  • Integrations may require more IT involvement than plug-and-play solutions.
• Pricing:
  • Quote-based pricing model for enterprise clients.

Who it's best for: Certified home health agencies that require deep clinical documentation and claims management capabilities alongside financial system integrations.

10. AlayaCare

AlayaCare is a modern, cloud-based home care platform that combines scheduling, clinical documentation, and a mobile caregiver app with powerful back-office tools. A key feature is its flexible REST API, which allows tech-savvy agencies to build custom integrations with nearly any payroll or accounting tool. For those preferring a simpler route, AlayaCare also offers guided integrations with common financial software.

• Pros:
  • Flexible and open API allows for extensive customization of workflows.
  • Combines traditional agency management with virtual visit capabilities.
  • Strong mobile-first design for caregivers in the field.
• Cons:
  • Custom integrations using the API will require technical resources.
  • May have more features than are needed by smaller, non-skilled private duty agencies.
• Pricing:
  • Subscription pricing based on modules and number of users; requires a custom quote.

Who it's best for: Forward-thinking home care organizations that want the flexibility to create custom, perfectly tailored financial workflows.

11. WellSky Personal Care

WellSky is a major player in health and community care technology, and WellSky Personal Care (which includes ClearCare, as noted above) is its flagship offering for private duty home care. It excels at caregiver scheduling, telephony/EVV, and client management. Through its established partner integrations, it provides reliable data handoffs to major payroll providers and supports seamless data flow into QuickBooks for handling billing and financial statements.

• Pros:
  • Deeply focused on the operational needs of private duty home care.
  • Proven integrations that are actively maintained and supported.
  • Backed by a large, stable company focused on the post-acute care market.
• Cons:
  • Less flexible than platforms with an open API for custom connections.
  • The user experience can sometimes feel dated compared to newer platforms.
• Pricing:
  • Pricing is provided through a custom quote based on agency size and needs.

Who it's best for: Private duty home care agencies that value stability and a proven track record in a market-leading operational platform.

Third-Party Connectors & Middleware

When a direct integration isn't available, these tools bridge the gap, enabling you to build custom workflows without coding.

12. Zapier

Zapier is an automation tool that lets you connect thousands of web apps. For home care, you can create "Zaps" to perform tasks like: "When a new employee is added to my HR system, create them in my payroll system." If your home care software can't connect directly to your accounting platform, Zapier can often act as the go-between, transferring invoice data or employee records automatically.

• Pros:
  • Supports over 6,000 apps, making it highly likely your tools are included.
  • Very easy to use with a visual, no-code workflow builder.
  • Good for automating discrete, simple tasks (e.g., creating a new customer).
• Cons:
  • Recurring costs can add up, as pricing is based on the number of tasks you run.
  • Not suitable for transferring large, complex datasets like detailed payroll journals.
• Pricing:
  • Offers a limited free plan.
  • Paid plans scale based on the number of tasks and the update speed required.

Who it's best for: Agencies with a few specific, frustrating manual tasks between otherwise disconnected systems that they want to automate.

13. Make (formerly Integromat)

Make is a more powerful and visual automation platform than Zapier. It excels at multi-step, complex workflows with conditional logic. For instance, you could design a "scenario" to pull time entries, check them for errors, route them for approval, and then send the approved data to both payroll and accounting systems. It gives you finer control over how data is processed between systems.

• Pros:
  • Visual workflow builder makes it easy to map out complex processes.
  • More flexible and powerful for handling data transformation and logic than Zapier.
  • Pricing model based on operations can be more cost-effective for complex workflows.
• Cons:
  • Has a steeper learning curve than Zapier.
  • Fewer pre-built app connectors, though its HTTP and API modules are very powerful.
• Pricing:
  • Generous free tier to build and test scenarios.
  • Paid plans scale based on the number of operations per month.

Who it's best for: Agencies with unique or complex workflow needs that require more control and sophistication than simple point-to-point automation.

14. Workato

Workato is an enterprise-grade automation platform designed for integrating systems across an entire organization. For a large home care agency or franchise, Workato can orchestrate complex processes involving EHRs, billing systems, payroll, accounting, and more. It offers pre-built "recipes" for common business processes and has powerful security and governance features required by larger corporations.

• Pros:
  • Extreme power and flexibility for business-wide process automation.
  • Strong governance, security, and error-handling features.
  • Focus on enterprise-grade APIs and system connectivity.
• Cons:
  • Significantly more expensive than Zapier or Make.
  • Requires a higher level of technical expertise to implement and manage.
• Pricing:
  • Custom, enterprise-level pricing based on the scope of the integration work.

Who it's best for: Large home care enterprises and franchises that need to build, manage, and secure mission-critical automations across dozens of applications.

Final Thoughts

Connecting your home care software to your payroll and accounting platforms moves your agency away from chaotic manual entry and toward streamlined, accurate financial management. The right integrations provide a single source of truth for your data, freeing up your team to focus on client care and business growth rather than chasing paperwork.

Beyond properly connecting systems, ensuring compliance with complicated home care labor laws and tax regulations is an ongoing challenge. This can lead to hours of research into state-specific overtime rules, complex payroll tax withholding, and unique industry deductions. To make that research instant, our AI tax research platform, Feather AI, gives you direct, AI-backed answers from authoritative sources like the IRS and state tax codes, helping you resolve complex compliance issues accurately and in a fraction of the time.