Cost of Full-Time Home Care Nearly Equal to Median National Household Income

Home care is frequently touted as one of the most affordable care options for seniors. But the average cost of full-time home care is nearly equal to the median household income in the U.S., a new report suggests.

Specifically, 44 hours of home care per week annually costs 91.1% of the median household’s bring-home pay. In other words, the average family paying for full-time home care must spend 9 out of every 10 dollars on care.

That’s according to a recent report released by, a resource site for seniors and caregivers.


The report examines the cost of home-based care — which it defines as nursing care, therapy, homemaker services and companionship — by state using data from the U.S. Census Bureau, Genworth Financial and the Centers for Medicare and Medicaid Services (CMS).

As part of the report, zeroed in on the costs of full-time caregivers by state, while cross-referencing that information with median household incomes by state.

However, it’s worth noting that few seniors receive full-time care, a spokesperson for the National Association for Home Care & Hospice (NAHC) told HHCN. 


“As far as the costs in the report are concerned, very, very few home [care] patients receive 44+ hours of care per week, so the percentages mentioned have little bearing on the actual experiences of real patients,” the organization said in a statement. “NAHC supports policies to make home health care more accessible to all Americans because home is where almost all Americans want to be as they age, and home health care is considerably more cost-effective than institutional care.”

Maryland topped the list of most affordable states for home care, requiring only 65% of the median household income to finance full-time care. Meanwhile, West Virginia and the District of Columbia ranked numbers two and three in terms of affordability, requiring almost 69% of median household income.

Connecticut was fourth on the list at nearly 71% and New Jersey was fifth, with people spending nearly 72% of their annual household income on full-time home care.

Washington was the least affordable state for home care with households spending roughly 145% of the median income on full-time care, followed by Maine at over 112%, Montana at over 108%, Oregon at 106% and South Dakota at over 105%.

Over the years, health care policymakers have attempted to lower spending by moving care into the home.

Indeed, in-home care is more affordable than nursing homes, where the annual median costs ranging from more than $80,000 to $100,000 nationally. Home care is comparable in cost to assisted living, which costs about $50,000 per year nationally, according to the report.

Given these costs, some industry insiders have pointed to group care as a less expensive alternative.

“We think that personal care — one-to-one care — is vital, but we believe that one-to-one care is becoming increasingly expensive, and we think the solution over the long term is group care,” former Addus HomeCare Corporation (Nasdaq: ADUS) CEO Mark Heaney previously told HHCN. “Group care will often be adult day services.”

Heaney comments came during a discussion about a multisite, multidisciplinary system of community care services he’s working to create through a new private equity partnership with New York-based private equity firm Post Capital Partners. Adult day will likely be part of the puzzle, he said.

Meanwhile, the demand for caregivers is expected to rise through 2026, growing by 47% and surpassing demand for all occupations, which is projected to increase by only 7%. Workforce shortage remains a key challenge for the in-home care industry with 76% of adults saying they’d prefer to age in place, according to AARP statistics.

Additionally, total spending on in-home care will reach close to $200 billion by 2027, amounting to a 72% increase between 2011 and 2027.

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