Home care in the U.S. - Statistics & Facts
Most Americans want to age in their homes. In fact, in a survey from 2024, 75 percent of U.S. adults aged over 50 years said they would like to reside in their current residence for as long as possible. To avoid institutional care, older adults (or those with disabilities) may need one or a combination of two types of home care: home care and home health care. Home care refers to non-medical care such as homemaker services (laundry, cooking etc.), assistance with activities of daily living/ADLs (walking, bathing etc.), personal care, or companionship. Meanwhile home health care must be prescribed by a doctor or nurse practitioner and is delivered by licensed medical professionals such as registered nurses, physical therapists, etc. Medicaid and Medicare are the largest payers in home health spending in the United States, but much is also paid out of pocket. While Medicaid home health eligibility varies by state, Medicare only covers intermittent home health care (short term care after an injury or illness) but not home care services alone.
Comparing home health care costs to facility-based options
While home care may be the cheaper option if only a few hours of care a day is needed, it can quickly add up to being more expensive than facility care such as assisted living residence. For example, if only 10 hours of home care is needed per week, this comes to roughly 1,400 U.S. dollars per month with an average pay of 33 U.S. dollars per hour for home health aides. However, if full-time care of 40 hours a week is required, fees would likely exceed that of assisted living, not including other monthly living costs such as rent, water, and food. An alternative could be community services such as adult day health care. Meanwhile, a nursing home offers the most comprehensive, round-the-clock nursing care and is correspondingly the most expensive at 116,800 U.S. dollars a year on average for a private room.Patient satisfaction remains high despite record turnover rates
Like many other health sectors, the home care industry in the United States continues to face significant workforce challenges, with turnover rates remaining persistently high. In 2023, the median turnover rate for professional caregivers reached 79.2 percent, marking a substantial increase from the 64.9 percent recorded just two years prior. Despite the high turnover rates, patient satisfaction with home health services remains remarkably positive. As of October 2024, 85 percent of surveyed home health patients gave their agencies a rating of 9 or 10 on a scale from 0 to 10. Additionally, 78 percent of patients reported they would definitely recommend their home health agency to friends and family.Still, insufficient staffing is impacting the industry, with large shares of home health agencies having to reject patient referrals. Access to home health care will increasingly be an issue in the United States in the face of an ever-growing elderly population’s wish to age at home.
