Home care includes several distinct measures: paid home health services, personal-care work, Medicaid home- and community-based services, unpaid family care and home-based medical visits. The figures below make the population, period, geography and definition explicit so these measures are not treated as interchangeable.
Key Home Care Statistics
The most broadly useful figures include:
- In 2024, freestanding home health agency spending reached $169.4 billion in the United States.
- In 2024, home health care represented 3% of U.S. national health expenditures.
- In 2024, freestanding home health spending grew 10.2% from 2023 in the United States.
- In 2017, approximately 4.4 million traditional fee-for-service Medicare beneficiaries were homebound in the United States.
- During 2011–2017, 11% of homebound U.S. fee-for-service Medicare beneficiaries received home-based medical care.
- During 2011–2017, home-based medical-care recipients averaged 7.74 visits per recipient-year.
- In 2021–2022, one in five rural adults in 47 states and Puerto Rico were caregivers.
- In 2021–2022, 58% of rural caregivers in 47 states and Puerto Rico were women.
- In 2021–2022, a third of rural caregivers provided at least 20 hours of care per week.
- In 2023, 3,961,900 people were employed as home health and personal care aides in the United States.
- BLS projects 4,782,400 U.S. home health and personal care aide jobs in 2033.
- BLS projects about 718,900 annual openings for U.S. home health and personal care aides over 2023–2033.
- In May 2024, the median annual wage for U.S. home health and personal care aides was $34,900.
- In July 2024, private-sector employees in U.S. home health care services averaged 29.0 hours per week.
- From 2013 to 2019, home-care workers per 100 Medicaid HCBS participants declined 11.6% in the United States.
- In 2016, almost three-quarters of U.S. older adults with disabilities received informal home care.
- In 2005, Medicaid HCBS had 2.2 million users in the United States.
- During 2011–2017, 75% of people receiving home-based medical care in the study were homebound.
Contents
- Home care spending and market scale
- Medicare home care use and access
- Unpaid family caregiving
- Home care workforce pay and hours
- Home care workforce trends and capacity
- Home-based medical care population patterns
Home Care Spending Statistics and U.S. Market Scale
The National Health Expenditure Accounts measure freestanding home health agencies as a specific service category. That boundary matters: hospital-based agencies are classified with hospitals, and the category does not represent unpaid care or all institutional long-term care.
| Measure | Period | U.S. figure |
|---|---|---|
| Freestanding home health agency spending | 2024 | $169.4 billion |
| Home health share of national health expenditures | 2024 | 3% |
| Freestanding home health spending growth | 2024 vs. 2023 | 10.2% |
| Home health spending growth | 2023 vs. 2022 | 11.1% |
| Total national health spending | 2024 | $5.3 trillion |
Source: NHE24 Highlights, the Centers for Medicare & Medicaid Services’ 2024 National Health Expenditure Accounts summary. These are annual estimates, and total health spending is contextual rather than home-care spending.
The 2024 home health figure therefore describes a large, defined spending category rather than the entire economic value of care delivered at home. The 10.2% annual increase is also an estimate for freestanding home health agencies, not a growth rate for every form of home care.
Medicare Home Care Use and Access Statistics
A Health Affairs study linked the National Health and Aging Trends Study with Medicare claims for community-dwelling older fee-for-service beneficiaries during 2011–2017. Its definition of home-based medical care required at least two home visits around the interview date, so the results should not be read as a utilization rate for every Medicare beneficiary.
Among 7,552 respondents, 4.97% received home-based medical care. The study identified 2,486 homebound and 5,066 not-homebound respondents, while a separate estimate put the 2017 homebound traditional fee-for-service Medicare population at approximately 4.4 million.
- 11% of the homebound population received home-based medical care during 2011–2017.
- The detailed study estimate was 11.26% among 2,486 homebound respondents.
- 1.88% of 5,066 respondents classified as not homebound received home-based medical care.
- Recipients averaged 7.74 visits per calendar year, while homebound recipients averaged 7.64 visits.
- Recipients who rarely or never left home averaged 8.47 visits per year; those who left home but never by themselves averaged 6.32 visits.
- Respondents who left home with help or difficulty had a 5.47% receipt rate.
Source: Receipt Of Home-Based Medical Care Among Older Beneficiaries Enrolled In Fee-For-Service Medicare. The study is observational and its visit definition is narrower than all possible home care.
Unpaid Family and Rural Home Caregiving Statistics
The CDC’s 2021–2022 Behavioral Risk Factor Surveillance System rural analysis describes caregiving as regular care or assistance provided to a friend or family member with a health problem or disability. The geography is rural adults in 47 states and Puerto Rico, not all U.S. adults.
| Rural caregiver measure | 2021–2022 estimate |
|---|---|
| Rural adults who were caregivers | One in five |
| Women among rural caregivers | 58% |
| Caregivers age 65 or older | 29% |
| Caring for a parent or parent-in-law | 33% |
| Caring for someone with dementia | 20% |
| Providing at least 20 hours weekly | A third |
| Managing household tasks | Over 80% |
Source: Caregiving Among Rural Adults. The rounded expressions are retained from the CDC infographic, and the task categories are self-reported.
These data capture unpaid support that sits outside the CMS spending category and outside paid aide employment. They also show why “home care” is not a single participation measure: a caregiver may provide household help, dementia support or substantial weekly hours without appearing in a paid-care utilization statistic.
Home Care Workforce Statistics: Employment, Pay and Hours
The Bureau of Labor Statistics combines home health aides and personal care aides into an occupation for its outlook page. Wage estimates exclude self-employed workers, and industry averages should not be presented as the price a household pays for a visit.
| Workforce measure | Period | Figure |
|---|---|---|
| Home health and personal care aide employment | 2023 | 3,961,900 |
| Median annual wage | May 2024 | $34,900 |
| Lowest-paid 10% threshold | May 2024 | Less than $25,600 |
| Highest-paid 10% threshold | May 2024 | More than $44,190 |
| Median pay in home healthcare services | May 2024 | $35,250 |
| Average hours in private home health care services | July 2024 | 29.0 per week |
| Average annual wages per employee in home health care services | 2023 | $39,780 |
Source: Home Health and Personal Care Aides: Occupational Outlook Handbook and Economic trends: home and community-based care versus institution-based care.
For comparison, private-sector employees in services for the elderly and people with disabilities averaged 29.4 hours per week in July 2024, and average annual wages per employee in that broader services industry were $26,496 in 2023. Those industry figures cover broader employee groups and are not aide-only measures.
Home Care Workforce Trends and Service Capacity
BLS projects continued expansion for the combined home health and personal care aide occupation, while Health Affairs documents a different capacity question: whether the workforce kept pace with Medicaid home- and community-based services participants.
| Measure | Period | Figure |
|---|---|---|
| Projected aide employment | 2033 | 4,782,400 jobs |
| Projected increase | 2023–2033 | 820,500 jobs |
| Projected employment growth | 2023–2033 | 21% |
| Projected annual openings | 2023–2033 | About 718,900 |
| Historical workforce ratio change | 2013–2019 | Down 11.6% per 100 Medicaid HCBS participants |
Source: Home Health and Personal Care Aides: Occupational Outlook Handbook and The Home Care Workforce Has Not Kept Pace With Growth In Home And Community-Based Services.
The BLS figures are forecasts, not guaranteed future headcounts, and the annual openings include exits and occupational transfers as well as net-new jobs. The Health Affairs ratio is derived from separate workforce and HCBS participant series; it is not the same measure as total employment growth.
The Health Affairs review estimated that the home care workforce grew from about 840,000 workers in 2008 to 1.22 million in 2013 and about 1.42 million in 2019. Its review also described more than two million personal care aides and about 800,000 home health aides around 2019, using occupation definitions that differ from the combined BLS category.
The same review cited a historical projection that the reviewed home health and personal care aide occupations would grow more than 40% from 2016 to 2026. That is a historical forecast, not a current estimate of observed growth.
Home-Based Medical Care Population Patterns and Outcomes Context
Home-based services reach populations with different eligibility and vulnerability profiles. Medicaid HCBS users and Medicare home-based medical-care recipients should therefore be described separately from informal caregivers and paid aide employment.
The Health and Retirement Study estimated that almost three-quarters of older U.S. adults with disabilities received informal home care in 2016. Informal care is distinct from paid agency care, so this result cannot be combined with the paid workforce or Medicare visit measures.
Medicaid HCBS data provide another historical population benchmark:
- The Medicaid HCBS population numbered 2.2 million users in 2005.
- Medicaid HCBS users represented almost 4% of the total Medicaid population in 2005.
- Two-thirds of Medicaid HCBS users were dually eligible for Medicare and Medicaid in 2005.
Source: Users Of Medicaid Home And Community-Based Services Are Especially Vulnerable To Costly Avoidable Hospital Admissions. These are historical administrative-data estimates.
The Medicare study found that nearly 5% of its 7,552-person sample received home-based medical care at any point during 2011–2017, and 75% of recipients were homebound. Less than 2% of nonhomebound participants received care during follow-up, while recipients who were never or rarely out of the home averaged 8.47 visits annually.
Source: Receipt Of Home-Based Medical Care Among Older Beneficiaries Enrolled In Fee-For-Service Medicare. The follow-up averaged 3.4 years per person, and the study identifies patterns of receipt rather than causal outcomes.