National Health Expenditures

$3.2 Trillion

Source for expenditure data:
Centers for Medicare & Medicaid.
CMS National Health Expenditure Data, Table 10.

Home Health Expenditures

$88.8 Billion

2016 projected
$94.1 Billion

Includes all U.S. home health expenditures.

Between 2014 and 2015, Medicare spending on home health care increased by 2.3% to $18.1 billion.

Medicare spending on hospice was $15.9 billion.

Home Health AgenciesThe number of HHAs increased from 7,057 in 2002 to 12,346 in 2015.
HospicesThe number of hospices increased from 2,323 in 2002 to 4,199 in 2015.

The U.S. Census Bureau reports 30,139 establishments providing home health care services, and 1,101 of those as franchise establishments.

Medicare Beneficiaries

In 2016, Medicare home health served 3.7 million persons and hospice served 1.4 million persons.

Nearly half, 45.2% of home health users had a diagnosis of diabetes, and 37.9% had a diagnosis of depression.

96.4% of home health users needed assistance with bathing.

Source: CDC/NCHS: National Study of Long-Term Care Providers, 2013-2014.


98.2 million
The projected population of people age 65 and older in 2060. Nearly one in four Americans will be in that age group.

19.7 million
Persons in the above age group that will be age 85 or older in 2060.

Source: U.S. Census Bureau. Profile America Facts for Features: CB17-FF.08. April 10, 2017.

Marginal profit for freestanding home health agencies averaged 18.1%.  MedPAC projects Medicare margins for 2017 will equal 13.7%.

Aggregate Medicare margin for hospices in 2014 was 8.2%. MedPAC projects an aggregate Medicare margin of 7.7% for 2017.

Medicare Home Health 2015
  • 33 visits per user
  • 18.8 visits per episode
  • 1.9 episodes per user
  • $5,225 payment per user
  • $2,965 payment per episode
Medicare Hospice 2015
  • 86.7 days, average LOS
  • 17 days, median LOS
  • $149 average cost per day, all hospices
  • $134 average cost per day, for-profits
  • $173 average cost per day, nonprofits
Medicare Home Health and Hospice
Agency Type Home Health Hospice
Freestanding 90.6% 72.5%
HHA-based 13.0%
Hospital-based 8.6% 13.8%
SNF-based 0.8% 0.7%

Source: Fazzi analysis of Medicare cost report data.

Home Health Visits by Discipline
Type of Visit Visits per Episode (2015)
Skilled Nursing 9.6
Therapy 7.1
Home Health Aide 2.0
Medical Social Services 0.1

Source: Fazzi analysis of Medicare claims data.

Hospice LOS by Diagnosis

50th Anniversary of
Medicare & Medicaid

Medicare Anniversary

Health, United State Spotlight Health Care Expenditures & Payers
September 2016

United State Spotlight September 2016Source: CDC. Centers for Disease Control and Prevention

Health, United States Spotlight Selected Health Indicators
Winter 2016

United States Spotlight Winter 2016Source: CDC. Centers for Disease Control and Prevention