Rising Home Care and Falling Wages: The Impact of the Growing Share of Home Care Workers on Direct Care Worker Wages

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. 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.