The hunt for the next big industry is never easy, but at-home health care looks especially auspicious for multiple reasons. Perhaps the most obvious is America's rapidly aging population. As the older Baby Boomers approach their 70s, health care industries across the board are anticipated to show substantial growth. NAS recruitment Innovation predicted health care sector employment prospects to grow by 29% from 2012-2022 compared to a national average of only 11%. Part of this growth is due to the recently passed Affordable Care Act. The act provides numerous benefits for the elderly by making preventative care and medication more available and less expensive.

What makes at-home services special?
Chiefly, American's perpetual desire for more  convenient options has driven at-home care up in popularity. This care is also often less expensive than traditional nursing homes, and the value proposition might help drive uptake. The Bureau of Labor Statistics seems to agree. In their 2010-2020 employment and output outlook report, the Bureau reported Home Health Care services as the number one fastest growing industry this decade. They project growth to occur at an astounding 6.1% per year through 2020.

Top players in the industry
Given this seemingly universal positive sentiment, which company within the sector will produce the most consistent profits for years to come? One potential leading player is Amedisys Incorporated (NASDAQ:AMED). Amedisys is the nation's leader in home health care with a 4.85% share of the market. In addition, the company is fourth in the nation with a 1.61% share of the hospice market. A second that stands out is Gentiva Health Services (UNKNOWN:GTIV.DL). Gentiva is second in the nation in both at-home health services and hospice with a 4.76% share in the former market and a 4.82% share in the latter.But it is not just market share that makes these two companies so alluring.

Amedisys Incorporated is best known for its modern, patient oriented approach toward care. They are the first at-home health care provider to implement a Care Transitions program, which was created to reduce unnecessary hospital readmission with care coordination between the physician and the home health team. By ensuring their patients' quality care in the most convenient fashion, Amedisys looks to profit in coming years after many quarters of poor performance. 

It appears this turn-around can be attributed to a dramatic cost-cutting initiative that began in early 2014. In the second quarter, for example, Amedisys closed 29 of its worst performing centers and consolidated an additional 25. By focusing instead on the 400 centers with adequate performance, Amedisys could be seeing solid quarterly profits for the first time in years. In fact, revenue for the second quarter is expected to be over $300 million with an estimated earnings per share in the range of $0.15 to $0.20. This profit came as a surprise to analysts; Amedysis was predicted by most to stay in the red or at best break-even in the second quarter. As the company continues to "trim its fat," it may start turning in a consistent profit.

Gentiva Health Services
Gentiva Health Services could also could be poised for growth in coming quarters. The market hasn't been too impressed with its large market share, and I think Gentiva's current market cap undervalues the stock. Of course, the low price could be due to its struggle to turn a profit in recent years. Similar to Amedisys, however, Gentiva seems to be the process of a dramatic turn-around.

Gentiva reported positive first quarter 2014 numbers, including adjusted EPS of $0.13, higher than analyst estimates but lower than last year's $0.23. This profitability seems to have stemmed in part from the company's recent acquisition of Harden Healthcare which was finalized at the end of 2013. Harden, which is another home health care and hospice provider, helped increase Gentiva's already strong market share in the Industry. Gentiva also reached an agreement with Wake Forest Baptist Medical Center to help benefit post-acute services. 

As Gentiva looks to diversify even more in 2014 with agreements and acquisitions, it is also being actively pursued by Kindred Healthcare. Gentiva executives have rejected Kindred's bids thus far. Kindred, a long term care provider, is offering a $534 million cash takeover bid. This bid means Kindred is valuing Gentiva at $14.50 per share (less than Gentiva is currently trading for, but a substantial increase over what Gentiva was trading for previous to the offer). Gentiva has rejected the offer -- management has even put into place a poison-pill to help prevent an unwanted takeover. Whether the takeover occurs or not, it is a good sign for potential investors that a major sector company such as Kindred is making such an aggressive offer.

Neither of these companies is a slam-dunk by any stretch, but I think that the rising tide of growth in the at-home and hospice health care industries may help these two giants grow as well. Potential investors, however, should remain very cautious about these plays. Both have been traditionally volatile stocks to own, and neither has shown consistent profit in recent years. There is, however, much room for potential growth for both companies. Whether they can deliver will be the next big question.