Findings on Managed Care Reported by Researchers at University of Pennsylvania (Rising Home Care and Falling Wages: The Impact of the Growing Share of Home Care Workers on Direct Care Worker Wages): Managed Care

2026 MAR 16 (NewsRx) -- By a News Reporter-Staff News Editor at Insurance Daily News -- Research findings on Managed Care are discussed in a new report. According to news reporting out of Philadelphia, Pennsylvania, by NewsRx editors, research stated, “Over the past several decades, Medicaid’s expansion of home- and community-based services (HCBS) has facilitated a shift in the direct care workforce from institutional settings to home care settings. Although this shift is well documented, less is known about its impact on the hourly wages of direct care workers.”

Our news journalists obtained a quote from the research from the University of Pennsylvania, “This study examines how the rising proportion of home care workers in the direct care workforce has been associated with wages of the 2 groups that constitute this workforce-home care and institutional care workers-and the overall direct care worker wages. An observational study using pooled data from the 2008-2012 and 2018-2022 American Community Survey AND PARTICIPANTS: The sample includes direct care workers-personal care aides, home health aides, and nursing assistants-in 50 states and Washington, DC. We adopt first-differences models at the state level to analyze trends in the direct care worker composition and wages over the recent decade. Increases in the share of home care workers are associated with a decline in direct care worker wages but no changes in the wages of home care or institutional care workers. This decline appears to be driven by the growing share of lower-paid home care jobs. These findings extend prior studies that have largely focused on the shift in the long-term services and supports (LTSS) toward HCBS with respect to Medicaid expenditures and worker supply, with less attention to worker compensation.”

According to the news editors, the research concluded: “By doing so, we highlight a critical policy challenge: without improving compensation for home care workers, continued rebalancing of LTSS toward home-based settings may worsen workforce shortages.”

This research has been peer-reviewed.

For more information on this research see: Rising Home Care and Falling Wages: The Impact of the Growing Share of Home Care Workers on Direct Care Worker Wages. Journal of the American Medical Directors Association, 2026:106149. Journal of the American Medical Directors Association can be contacted at: Elsevier Science Inc, Ste 800, 230 Park Ave, New York, NY 10169, USA. (Elsevier - www.elsevier.com; Journal of the American Medical Directors Association - http://www.journals.elsevier.com/journal-of-the-american-medical-directors-association/)

Our news journalists report that additional information may be obtained by contacting Jiyeon Kim, University of Pennsylvania, Philadelphia, PA, United States. Additional authors for this research include Pilar Gonalons-Pons and Janette Dill.

Publisher contact information for the Journal of the American Medical Directors Association is: Elsevier Science Inc, Ste 800, 230 Park Ave, New York, NY 10169, USA.

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