Home Health Care Workers

Home Health Care Workers in United States

United States

Home health and personal care aides enable older adults to remain in their homes as they age — a preferred care option for many. These aides provide short-term skilled nursing services, such as aiding in recovery from surgery, as well as long-term care for those with disabilities, functional decline or chronic illness. 

The number of adults ages 65 and older is projected to increase from 56 million to 73 million by 2030. The need for home health and personal care aides is therefore projected to grow much faster than the national average for all occupations, with a predicted 924,000 jobs added between 2021 and 2031.

Home- and community-based services are less expensive care options than institutional care settings like nursing homes. Annual estimated costs for nursing home care were $94,900-$108,405 in 2021, compared with approximately $60,000 for home health care services. Annual spending for Medicaid home- and community-based services was $92 billion in 2018. Using home- and community-based services may lead to cost savings in the long-term care sector.

Adults ages 65 and older make up the majority of patients who use home health care services. The use of home health care services is higher among:

• Adults ages 75-84 compared with those ages 65-74 and those ages 85 and older.
• Women compared with men. 
• Older non-Hispanic white adults compared with all other racial groups.

While Medicare often covers home health care services when an older adult has medical needs and is homebound or entering hospice, it does not cover ongoing supportive care. The Affordable Care Act allows states expanded options to pay for home- and community-based services through state Medicaid benefits and provides new funding opportunities through the State Balancing Incentive Program. Programs of All-Inclusive Care for the Elderly (PACE), a Medicare and Medicaid initiative, is a program for older adults who need nursing home-level care and are seeking assistance paying for home health care.

County Health Rankings offers several evidence-based strategies for increasing the quality of home health care services and decreasing negative health outcomes for older adults. These strategies include an integrated long-term care model to address the needs of older adults who reside in the community and a case management model to coordinate care across a team.

The Department of Health and Human Services offers an Eldercare Locator to identify home health care services for older adults.

Kaye, H. Stephen, Mitchell P. LaPlante, and Charlene Harrington. 2009. “Do Noninstitutional Long-Term Care Services Reduce Medicaid Spending?” Health Affairs 28 (1): 262–72. https://doi.org/10.1377/hlthaff.28.1.262.

“Long-Term Care in America: Americans Want to Age at Home.” 2021. Issue Brief. The AP-NORC Center for Public Affairs Research. https://www.longtermcarepoll.org/wp-content/uploads/2021/04/LTC_Report_AgingatHome_final.pdf.

Sengupta, Manisha, Jessica Penn Lendon, Christine Caffrey, Amanuel Melekin, and Priyanka Singh. 2022. “Post-Acute and Long-Term Care Providers and Services Users in the United States, 2017–2018.” National Center for Health Statistics (U.S.). https://doi.org/10.15620/cdc:115346.

Watts, Molly O’Malley, MaryBeth Musumeci, and Priya Chidambaram. 2020. “Medicaid Home and Community-Based Services Enrollment and Spending.” Issue Brief. KFF. https://www.kff.org/report-section/medicaid-home-and-community-based-services-enrollment-and-spending-issue-brief/.