More than nine million U.S. residents rely on long-term services and support for help with everyday tasks such as dressing, bathing, and mobility. About 70% of those who use paid help overall are older adults. Demand for these services is projected to grow substantially in the coming decades as the population ages.

Using data from the American Community Survey and the Henry J. Kaiser Family Foundation, researchers compared trends in the size of the home care workforce with data on Medicaid Home & Community-Based Services (HCBS) participation between 2008 and 2020.

The study published in Health Affairs presents new evidence on national trends in the size of the home care workforce, comparing growth in this workforce with growth in Medicaid HCBS enrollment. The home care workforce grew from approximately 840,000 to 1.22 million workers between 2008 and 2013. After 2013, growth slowed, reaching 1.42 million workers in 2019.