Pennsylvania Home Health Agencies Warn of Crisis Amid Aging Population, Staffing Shortages

Pennsylvania’s in-home health care agencies are facing significant financial and staffing challenges amid a rapidly aging population. Providers delivering essential services such as skilled nursing, physical therapy, and personal care report that low Medicaid reimbursement rates, set by the state, are unsustainable and contribute to service instability. Historically low funding and staffing shortages have led to an estimated 112,500 unfilled home care shifts per month statewide.

The Pennsylvania Homecare Association has highlighted that many workers earn an average base wage of just $15.69 per hour, limiting the industry’s ability to retain and attract staff, especially compared to neighboring states like New Jersey and New York where wages are higher. The state legislature, divided politically, is currently negotiating budget allocations, and home care advocates are urging for an additional $370 million in funding this year to address wage increases, new hires, and service expansion. This amount represents a 10% increase in reimbursement rates, which is part of a much larger estimated need of $856 million to realign reimbursement with competitive market rates. The slow legislative movement and limited budget proposals—Governor Josh Shapiro’s budget suggesting only a $21 million increase for certain care workers—raise concerns that staffing shortages will worsen, possibly forcing families to opt for higher-cost care settings like nursing homes prematurely.

An independent state-commissioned study noted that reimbursement rates for some services have remained stagnant for over a decade, exacerbating financial pressures on providers. The crisis poses systemic risks to the home care market in Pennsylvania, impacting care quality, provider viability, and patient choice. If unaddressed, these challenges may accelerate outmigration of home care workers and increase demand for institutional care facilities, straining both families and state resources. The issue underscores larger regulatory and fiscal challenges in managing Medicaid reimbursements to adequately support the growing demand for in-home health services amid demographic changes in Pennsylvania.