This article is a part of your HHCN+ Membership
The coming year is going to be defined by the tension of strong but opposing forces in the personal home care market. One major source of tension: as demand rises, labor costs have increased and home care is becoming unaffordable for many consumers. Another likely source of tension: The midterms could lead to divided government in the nation’s capital, heightening the tension between the legislative and executive branches, with implications for home care.
The good news is that technology, business models, new approaches to care and other innovations and changes are creating opportunities for enterprising providers.
The home care industry is at an inflection point – and HHCN believes the trends below will define what comes next.
Curious what we forecasted for last year? Revisit our 2025 home care predictions.
AI makes pajama time a caregiver dealbreaker
With staffing being the top challenge for the home care industry, any technique to ease workforce pressures is not only welcome – it’s essential for home care providers’ success.
AI has been hailed as a necessity for the home care industry to improve efficiency and remain viable. But it will also become a prerequisite for caregivers seeking employment.
New AI tools can help caregivers with a slew of documentation-related tasks, lightening the caregivers’ workloads. Providers that have prioritized technology implementation have already started to see results.
“One of the biggest [impacts technology has had] is just helping with retention, helping with quality of life,” David Kerns, CEO of the LTM Group, previously told HHCN. “We did a big [initiative] called pajama time, where we were eliminating time [spent documenting after work hours].”
In 2026, the importance of workforce-focused technologies – specifically those leveraging AI – will go beyond retention. Highly in-demand caregivers, who often have their pick of home care companies to work for, will begin to ask specifically for the jobs that have AI-enabled support systems to relieve the pressures of the caregiving career.
When AI can make their jobs so much easier, and the number of companies seeking new caregivers abounds, AI will be a breaking point for caregivers on the job hunt.
Resisting shrinkflation
Consumers are increasingly faced with “shrinkflation” – the price of an item stays the same, but the amount or quality of the item decreases as labor and raw material costs rise for manufacturers. Think smaller chocolate bars, containing less real chocolate, sold at the same price.
While this phenomenon is becoming all too common in grocery store aisles, consumers will reject it among their home care providers. Standards for home care – including a desire for the same caregiver and smooth scheduling and communication – have only risen, especially among the “sandwich generation.” This generation is caring for both aging family members and their own children and requires a home care provider that is accredited and well respected in their communities.
However, home care providers are already dealing with difficult-to-find and expensive labor costs, making it difficult to provide continuity of caregiver, along with other factors that busy clients look for in their provider.
On top of that, home care is already becoming too costly for many families, prompting providers to find ways to keep home care affordable while prioritizing quality.
In 2026, the name of the game for providers will therefore be to keep costs the same without making the metaphorical candy bar any smaller.
Non-medical no longer means non-acute
Home care has always been a crucial part of the health care continuum, but providers are starting to more actively support the patients on the most acute side of the health care continuum.
Providers have increasingly expanded into high-acuity patient service lines, from chronic disease to cancer care. While expanding into new service lines is not a new trend in home care, in 2026, extending into the highest-acuity patients will be the next evolution of this trend.
Fast-adapting providers that step boldly into this new era of home care will differentiate themselves from their peers and enable themselves to expand their patient pools, referral pipelines and word-of-mouth power. Providers that stick to the more bread-and-butter patients, meanwhile, may find demand for their services slightly soften in comparison.
Of course, early adopter providers that expand to care for higher acuity patients also have to contend with more complex cases – and therefore have to be prepared with the right workforce, training systems and technology before making the leap.
CDPAP sets the negative example
This year, New York’s consumer-directed home care program set a standard – a bad standard. The CDPAP situation showed many of the risks in overhauling at-home care programs, and the intensity of backlash that follows when changes are not implemented well . Caregivers and consumers broadly contested the highly fraught transition to a single fiscal intermediary and some providers left the state, saying it was no longer financially viable to continue operating there.
Providers that stayed the course faced disastrous consequences, reporting layoffs, loss of revenue and the complete closure of operations. Stakeholders in New York hope for a complete 180-degree pivot from the state’s Department of Health and Human Services.
“I’m hoping at some point, officials with the capacity to undo this contract and move forward and make sense for the state of New York — do that,” Bryan O’Malley, executive director of the Consumer Directed Personal Assistance Association of New York State (CDPAANYS), previously told HHCN. “This has been extremely disruptive to home care in New York … the transition has not had hiccups, it’s been a disaster.”
The CDPAP fiasco of 2025 holds lessons for 2026 and beyond, and should inform any efforts at restructuring home care programs, particularly any changes resulting from the dramatic Medicaid cuts in the One Big Beautiful Bill Act (OBBBA). A silver lining of the CDPAP debacle is that it underscored how crucial at-home care is for those who need these services, and how this population and sector can mobilize, advocate and draw attention to the cause of better public policy – even if this particular battle has not ended in anything like a clear-cut victory.
Midterms will tell the workforce tale
In 2025, President Donald Trump’s immigration enforcement worsened an already tenuous caregiver pipeline, causing caregivers to lose jobs and clients to lose their caregivers. While Trump still has three years in office – and a legacy that will echo throughout Washington, D.C. for decades to come – in 2026, the home care industry could get a taste of the future of these immigration policies.
This year, providers will see if politicians who support more lenient immigration policies will be successful in elections across the country. Democrats, who typically support such policies, are currently poised to have a dramatic lead over Republicans in the 2026 midterms, according to an NPR/PBS News/Marist national survey.
Even if Democrats win a majority in both houses of Congress, comprehensive immigration reform surely will not come to pass, but Congressional action could meaningfully affect two major workforce-related concerns: the effect of U.S. Immigration and Customs Enforcement (ICE) actions and changes to visa policies.
Democrats are seeking additional guardrails on Department of Homeland Security funding in the wake of the shooting of Renee Good by an ICE officer, including warrants for civil immigration arrests and prohibiting the ICE officers’ use of masks (not to mention the impeachment of Homeland Security Secretary Kristi Noem). ICE crackdowns threaten the sustainability of the home care workforce, of which one in three home care workers is an immigrant. Measures like warrant requirements and mask bans could decrease the number of apprehensions and arrests – and possibly reduce the fear felt by immigrants, both documented and undocumented – thereby slightly improving conditions for immigrant home health care workers as well as the home health workforce landscape.
Democrats have also sought to create a caregiver visa, expand temporary work visas for jobs with frequent worker shortages and change employment-based green cards – actions that would “stabilize and grow the aging services workforce,” according to LeadingAge.
The potential for gridlock in D.C. – which was exemplified by the recent record-breaking government shutdown – makes any major changes to current immigration policies unlikely in the short term. Still, the outcome of the midterms will determine whether the next two years will further empower current immigration crackdowns or turn the tide in another direction.
The caregiver holotype will transform
New home care models, like short-hour or task-based billing models, are transforming home care. Clients now may only receive a few short visits from a caregiver throughout the day, rather than having a caregiver with them for several-hour-long chunks of time. While there will always be clients who require almost constant care, shifting trends will require home care agencies to attract and retain a different type of caregiver.
Caregivers in these new models must be comfortable with more frequent travel to different homes within the same area and be more entrepreneurial. They will skew younger and expect different benefits than traditional caregivers, like company cars and clearer career paths.
Caregivers who excel in traditional home care may not want to switch to a radically different work model, necessitating that providers onboard a new pool of caregivers.
The caregiver holotype – the specimen upon which the caregiver species description is based – will therefore transform in 2026.
Home care providers embracing the future through new operating models will need to understand this holotype in order to find new and more effective ways of recruiting and retaining them.
Companies featured in this article:
