Home-Based Care Is Essential Infrastructure and a Measurable Value Driver

October 16, 2026

New white paper from Health Management Associates and TEAM Services Group

Home-based care is the practical infrastructure that allows older adults and individuals with disabilities to access care safely in their homes. Home-based care includes personal care, personal assistance, homemaker supports, and respite, which provide value to individuals who need services and their families, and that value also extends to the overall health care system.

HMA, with support from TEAM Services Group, conducted an analysis of evidence on the value of home-based care, including the value these services can provide to policymakers, health plans, providers, and people in need of support. The white paper includes an assessment of key evidence signals on the ability of home-based care to provide value, including its role in preventing avoidable utilization, extending time at home, stabilizing function and safety, and sustaining family caregivers.

Download the white paper to explore the evidence and six policy levers for designing higher-value long-term services and supports.

The evidence

The report draws on an evidence baseline review of more than 100 peer-reviewed studies, government evaluations, and policy reports covering Medicaid-funded personal care, personal assistance, homemaker services, participant direction, and respite.

Four pathways to value

Home-based personal care creates the strongest value case through four connected pathways:

1. Prevent avoidable utilization
   Adequate support and coordination can reduce emergency department and hospital use when unmet daily needs would otherwise contribute to a crisis.
2. Extend days at home
   Sufficient support can delay or prevent nursing facility placement and help people remain in their communities longer.
3. Stabilize function and safety
   Workforce continuity, participant direction, and reliable service delivery can support daily functioning and safer care.
4. Sustain family caregivers
   Formal supports and meaningful respite can preserve unpaid caregiving capacity. Very low-dose respite may not be enough to reduce caregiver strain.

Six policy levers for high-value home-based LTSS

Building upon the evidence assessment, the white paper also includes recommendations on policy levers needed to translate evidence into action including:

• Funding cost-effective services
• Stabilizing the workforce
• Measuring outcomes, service delivery, and substitution
• Maintaining flexible service delivery options
• Making respite meaningful
• Intervening before crises

Watch the companion webinar

Go deeper into the report’s findings in The Value of Home-Based Personal Care Services webinar. Hear experts discuss the evidence, value pathways, and policy opportunities that can help states, health plans, providers, and community partners strengthen home-based long-term services and supports. https://www.healthmanagement.com/insights/webinars/the-value-of-home-based-personal-care-services/

Published October 2026 by Health Management Associates. Financial support for this white paper was provided by TEAM Services Group. HMA retained full independent editorial control over the research, analysis, and perspectives presented.

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