Abby Care reaches eight states by turning family caregivers into paid employees

Why it matters

Abby Care is building software around one of Medicaid's hardest operational problems: turning informal family labor into auditable, reimbursable care. State rules, payer contracts and dependable clinical records will determine how quickly Nguyen can expand.

Abby Care now operates in eight states, training family members to become paid caregivers and supplying the software, clinical supervision and administrative machinery required to reimburse their work through Medicaid, according to a July 28 Forbes profile.

The model grew from Havi Nguyen's childhood in Baytown, Texas, where she helped her Vietnamese immigrant parents run a nail salon and became the household expert on Medicaid. Nguyen, now 26, told Forbes that she handled benefit applications and renewals and helped her sisters reach the right medical appointments.

Nguyen later studied computer science at Columbia University after teaching herself to code at 16, motivated by an interest in building video games. She interned at Google and Facebook, then encountered the home-care shortage while working at a San Francisco therapy provider serving autistic children. She founded Abby Care in 2021 around a direct conclusion: families were already providing much of the care, yet the health system rarely treated them as trained workers.

Forbes reports that Abby Care booked $15 million in revenue in 2025. Abby Care has raised $45 million in equity from investors including Khosla Ventures, Sequoia Capital and Thrive Capital, and was most recently valued at $225 million, according to Forbes. That total includes a $35 million financing reported by Axios on August 21, 2025.

A business built from Medicaid paperwork

Abby Care acts as a Medicaid home-care provider rather than sending families to search through government programs on their own. Eligible relatives or friends complete online coursework and in-person instruction that includes CPR and the Heimlich maneuver. After receiving the required state certification, caregivers become Abby Care employees and work with nurses to create care plans.

The wages come from Medicaid reimbursements routed through insurers. In Colorado, Forbes says caregivers receive at least $20 per hour. Abby Care handles employment, payroll, documentation and clinical oversight, turning care that was frequently unpaid into reportable work under a state health program.

That arrangement changed the finances of Jesse Vega and Deaunda Lira, the Colorado Springs couple at the center of the Forbes report. Vega, 49, experiences severe epileptic seizures. Lira, 52, left a medical billing job paying nearly $50,000 a year to care for him, while Vega had already stopped working at the Department of Defense because of his condition. They learned about Abby Care through a disability resource program in December 2025.

Their experience captures the labor problem Nguyen is pursuing. AARP estimates that 59 million Americans provided care to adults in 2024, contributing almost 50 billion hours valued at roughly $1 trillion. The estimate uses an average value of $20.41 per hour. Penn researchers have placed the annual cost to a middle-aged daughter caring for her mother at $80,000 to $100,000 when lost earnings, career advancement and quality of life are included.

AI handles documentation inside a clinical operation

Abby Care's technology sits inside a care operation. AbbyOS is described in public materials as software for care history, documentation, outcome tracking and operational workflows. AbbyAid, the caregiver application, supports time sheets, medical charting and questions to an AI medical assistant.

That structure matters because Medicaid reimbursement requires evidence that approved services occurred and that caregivers followed a care plan. The software gives Abby Care a standardized record across families while nurses retain responsibility for clinical supervision. Forbes says Abby Care employs roughly 80 staff nurses.

Abby Care describes the system as AI-powered and says its tools can flag clinical and documentation issues. Abby Care also reports 38% fewer hospitalizations after 120 days in a sample of 151 patients. The figure comes from Abby Care's own before-and-after analysis rather than an independently published clinical trial, so it remains an operating metric rather than validated medical evidence.

Eight states means eight operating systems

Abby Care operates in eight states, according to Forbes. Its public materials identify Colorado, Florida, Georgia, Indiana, Massachusetts, New Jersey and Pennsylvania among listed markets, while Forbes specifically names Colorado, Pennsylvania, New Jersey and Florida. Expansion requires Abby Care to qualify under each state's programs, obtain the necessary licenses, build insurer relationships and adapt training and documentation to local rules.

KFF found that 5.1 million people used Medicaid-funded home care in 2023 and that Medicaid covered nearly two-thirds of US home-care spending. Every state offers home care through waivers, but eligibility, covered services and reimbursement structures vary. States operated more than 300 Medicaid home-care programs in 2025.

Those differences set the pace for Abby Care's growth. Adding a state involves regulatory and clinical infrastructure alongside software deployment. Sequoia said in August 2025 that Abby Care was active in five states, up from a waitlist website when the investor first met Nguyen. Reaching eight states gives Abby Care a wider base, while the regulatory work becomes more demanding with each market.

Nguyen has kept Abby Care's founding story close to that operational burden. Abby Care's about page says she personally answered calls from families during its earliest period.

She started with families struggling to navigate benefits, then built payroll, certification, nursing and software around them. Abby Care's opportunity comes from the enormous amount of care already happening in American homes. Its test is whether Nguyen can make that work consistently reimbursable across states without losing the clinical controls Medicaid programs and insurers require.