According to the U.S. government, the fastest growing segment of the long term care industry is home health care. With a nearly 7% annual increase, spending on home health care exceeds spending growth for both nursing homes and retirement communities.

There are a few explanations for this:

  • Aging population: The growth of the long term care industry as a whole is increasing due to an aging population. The median age of Americans has increased from just over 28 years old in 1970 to just over 38 years old in 2018.
  • Chronic disease: Rates of chronic disease are increasing. This is due to many factors including increased rates of obesity, diabetes, and cardiovascular disease.
  • Lower costs: An average hospital stay in the U.S. costs nearly $11,000 according to HCUP. Outfitting a home with a refurbished hospital bed frame and hiring a home health care nurse can cost significantly less.
  • More comfortable: Most patients prefer to remain at home for long term medical care, particularly for chronic conditions. When the patient can receive equivalent levels of care, such as with hospital bed frames, comfort will often be the deciding factor.

Here are four facts to know about in-home care:

Home Care vs. Home Health Care

Home care is not the same as home health care. Home care consists of assistance with daily care activities, such as cooking, eating, dressing, bathing or showering, and using the toilet. Home care may also assist people with limited mobility to move about the home and get from home to medical appointments and shopping. Home care is not limited to patients who are confined to hospital bed frames, however. Varying levels of home care can be provided depending on the patient’s abilities.

Home care is typically paid out of pocket or by Medicaid. Home care is typically not covered by private insurance or Medicare.

Home health care consists of medical services provided by a skilled nurse. Home health care services include medical testing, rehabilitative or physical therapy, administration of medications, and some medical treatments, such as home dialysis. There may be some overlap between home health care and home care services, particularly for patients who are unable to leave their hospital bed frames. For example, home care assistants and home health care nurses may assist in changing catheter bags and reminding patients to take medication.

Medicaid, Medicare, and private insurance will typically cover home health care that is deemed medically necessary by a physician.


The costs of home health care can be significantly reduced by purchasing refurbished equipment or renting equipment (if the prognosis is not chronic). For example, the highest quality hospital beds on the market, such as Hill Rom patient beds, Resolution beds, and Stryker hospital beds, can all be found in refurbished condition. These refurbished hospital beds are repaired or rebuilt before being sold and are often accompanied by a warranty covering the repairs. Most importantly, these hospital bed frames are usually significantly less expensive than new equipment.

Medicare and private insurance can cover all or part of the costs associated with durable medical equipment, including hospital beds.

Home Health Care Agencies

Home health care agencies help patients and their families arrange for a nurse to provide in-home health care services. These agencies can also help patients navigate insurance coverage by identifying charges that will be covered by Medicare or private insurance. Insurance, whether private or Medicare, will often cover rehabilitative services and nursing services. These include:

  • Skilled nurses
  • Psychiatric nurses
  • Occupational therapists
  • Physical therapists
  • Speech therapists
  • Medical social workers

Depending on your insurance, in-home mental health therapists and counselors may also be covered.


Some in-home health care is intended to be temporary. For example, rehabilitation at home from a physical injury, surgery, or illness is often preferred by patients to rehabbing at hospitals and rehabilitation centers due to the differences in cost and comfort.

For some chronic conditions, long term home health care may be needed. For example, patients with dementia, cardiovascular or lung disease, or sever mobility limitations may be “homebound” under the criteria set by insurance companies and Medicare. Home health care is usually covered by insurance, as long as a physician periodically re-certifies that the patient is still homebound.

In-home care is often the best option when considering cost and comfort. Costs can be contained through the use of refurbished medical equipment, such as hospital bed frames.