Medicare has covered home health care since the program began in 1965. Medicare's home health benefit covers skilled nursing, therapy, and home health aide services for homebound beneficiaries. Use of the Medicare home health benefit has declined in recent years despite an aging population. Sixty-two percent of family caregivers view home care as a long-term or permanent solution for helping a loved one age in place. Medicare beneficiaries, especially those with chronic health conditions, are increasingly unable to access home health services, primarily because of misaligned payment and quality incentives, Medicare Advantage plan practices, and workforce shortages. Flournoy warned of a workforce reduction, saying: "Not only are individuals going to be exiting the healthcare field, but they're going to be exiting the workforce altogether to become family caregivers."

Sixty-two percent of family caregivers now view home care as a long-term or permanent solution for helping a loved one age in place, according to A Place for Mom's 2026 Home Care and Family Caregiving report. The New York City-based company, which operates an online platform connecting families with home care and senior living communities, surveyed 708 family caregivers with experience with nonmedical in-home care — people actively seeking care, those who had hired a caregiver, and those who had discontinued home care within the past year. When health needs change, families are more likely to increase or alter home care hours than move a loved one to a senior living facility, said Martin Hernandez, the company's general manager of family sales, who told Home Health Care News that home-based care services are likely to grow and stabilize as families commit for the long term.

The commitment does not release families from the work. After hiring a professional caregiver, family members shift from hands-on tasks to roles as "care coordinators" — managing appointments, transportation, and emotional support — and still report spending around nine to 13 hours a week coordinating care. "One of the biggest misconceptions is that bringing in home care means the family can step away," Hernandez said. Among respondents who had used home care for more than a year, 72% said it was easy to adjust schedules, services, or caregivers over time, while 81% of those who discontinued home care said they experienced scheduling disruptions.

Cost emerged as a large barrier: 45% of respondents cited expenses as the top reason for discontinuing home care services, and most families required an adjustment period, with many initially contracting a caregiver for numerous services before scaling back to essential needs such as bathing or mobility. Even so, 85% of long-term users described home care as good or very good value, 93% would recommend it to others, and 69% of current users said it reduced their daily stress.