Home Care Industry To Face 6.1m Job Openings By 2034 As Low Wages Fuel Turnover

The home care workforce is projected to add more new jobs than any other occupation in the U.S. over the next decade – but also projected to have over 6.1 million total job openings due to workers leaving the labor force.

While growing rapidly, the home care workforce is plagued by a multitude of challenges, according to a new report from PHI, a nonprofit organization dedicated to creating direct care jobs. Among those are low compensation, discrimination and poverty.

“The home care workforce is one of the largest and fastest growing occupations in the U.S. due to a combination of factors, including the rapidly expanding population of older adults, consumer preferences for aging and receiving care in place, and the “rebalancing” of long-term care toward home and community-based services (HCBS),” the report’s authors wrote. “Home care worker wages increased slightly over the past decade but remain low overall, leaving many workers in or near poverty and (along with other factors) driving high rates of turnover in this workforce.”

The report included personal care aides, home health aides, direct support professionals and in some cases, nursing assistants under the category of home care workers.

PHI found that the home care workforce has doubled over the last 10 years, from nearly 1.4 million in 2014 to almost 3.2 million in 2024. Most of these workers are employed as independent providers through Medicaid-funded consumer direction programs, with Medicaid payments constituting 68% of the $312.9 billion spent on HCBS annually.

The report also identified key issues that contribute to high levels of turnover in the industry – an issue that is top of mind for home-based care providers.

“Devoting time to retention is the most efficient, economical and successful way to deal with the workforce shortages today,” Bill Dombi, senior counsel for Arnall Golden Gregory law firm, previously told Home Health Care News.

Low compensation is a driving factor in both recruitment and retention, according to PHI.

Wages for home care workers have risen slightly over the last decade, from a median of $13.07 in 2014 to $16.77 in 2024, adjusted for inflation. On top of low wages, 46% of home care workers work only part-time, and 17% are only employed for part of the year.

“Home care wages remain low and, coupled with unstable and often part-time/part-year schedules, lead to low annual earnings and high rates of poverty and public assistance use for this workforce,” the report read. “In turn, the home care industry continues to struggle with high turnover and widespread workforce shortages, leading to the reduction and closure of vital services.”

Annually, home care workers earn a median income of just $22,429, according to the report, and 15% live in a household below the federal poverty level. Just over 40% live in low-income households.

Almost 60% of home care workers receive some form of public assistance, and 11% lack health insurance.

Demand for home care continues to ramp up, which will create over 681,000 new jobs between 2024 to 2034. Nearly 2.3 million job openings will be created by workers changing occupation, and almost 3.2 million will be caused by workers leaving the workforce completely.

To maintain quality and establish economic security for home care workers’ jobs, PHI recommends increased collaboration between home care stakeholders and lawmakers.

“Additional funding for HCBS through [the American Rescue Plan Act] (ARPA) expired in 2025, and major cuts to Medicaid through the recently passed federal reconciliation bill will threaten job quality and economic security for home care workers in the future,” the report read. “In response, state policymakers, home care providers, advocates and other leaders will need to collaborate more closely than ever to support and strengthen the home care workforce to meet growing demand.”

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