The Demand is Coming. Will Oregon Be Ready?

by Jamie Daugherty, Executive Director

Every week, healthcare leaders across Oregon face the same challenge: how do we meet growing demand for home-based care when workforce shortages, reimbursement pressures, and regulatory requirements continue to intensify?

The reality is that demand for home health, hospice, and in-home care services is no longer a future concern—it is happening now.

By 2030, every Baby Boomer will be over age 65, and one in five Americans will be retirement age. At the same time, patients increasingly prefer to receive care in their homes rather than in institutional settings. These demographic shifts are creating unprecedented demand for home-based services across the continuum of care. (Grand View Research)

For Oregon, the question is not whether demand will increase. The question is whether our healthcare system will have the capacity to meet it.

Home-Based Care Is Becoming the Preferred Model

Patients consistently report higher satisfaction when they can remain in familiar surroundings. Home-based care often leads to better outcomes, fewer hospitalizations, and lower overall healthcare costs.

As healthcare systems seek to reduce unnecessary hospital stays and improve transitions of care, home health and hospice providers are increasingly being viewed as essential partners rather than optional services. Industry experts continue to identify home-based care as one of the fastest-growing segments of healthcare. (CareVoyant)

This trend is particularly important in Oregon, where geography presents unique challenges. Many rural communities rely heavily on home-based services because institutional options may be hours away.

Demand Isn't the Problem—Capacity Is

The home care and hospice sectors are facing a paradox. Demand is rising, but agencies often lack the workforce and resources necessary to serve every patient who needs care.

National industry leaders consistently identify workforce shortages as the number one challenge facing providers. Recruiting and retaining nurses, therapists, aides, social workers, and other caregivers remains difficult, particularly in rural areas. (Home Health Care News)

Meanwhile, healthcare employment continues to grow faster than many other industries, reflecting the increasing need for services. Home health jobs alone have experienced significant growth since 2020. (The Washington Post)

For Oregon providers, these workforce challenges are compounded by travel distances, housing costs in some regions, and increasing competition for healthcare professionals.

Regulatory and Financial Pressures Continue

While demand is increasing, providers are also navigating mounting administrative responsibilities.

Hospice providers continue to face expanding reporting requirements and compliance expectations. Home health agencies are adapting to ongoing payment model changes and documentation requirements. Medicaid-funded services remain vulnerable to policy shifts at both the state and federal levels.

Many industry surveys indicate that concerns about profitability and operational costs are growing, even as patient need continues to expand. (AxisCare)

The result is a difficult balancing act: agencies must invest in workforce, technology, quality improvement, and compliance while maintaining financial sustainability.

Why This Matters for Oregon

Oregon has long been a leader in supporting care in the home and community. State leaders, providers, and advocates have worked together to create alternatives to institutional care that help individuals remain independent for as long as possible.

But success cannot be taken for granted.

As the population ages, policymakers must recognize that home-based care is not simply a lower-cost alternative to facility care—it is an essential component of Oregon's healthcare infrastructure.

Investments in workforce development, sustainable reimbursement, and reduction of unnecessary administrative burden will be critical to ensuring that patients continue to have access to care where they most want to receive it: at home.

Looking Ahead

The coming decade will likely be defined by one central healthcare question: how do we care for more people with increasingly complex needs while honoring their desire to remain at home?

The answer will require collaboration among providers, policymakers, payers, and communities.

The demand is already here.

Now we must ensure that Oregon is ready.

Call to Action: OAHC will continue advocating for policies that strengthen Oregon's home health, hospice, and home care workforce while protecting access to care for patients across the state. We encourage providers to share their workforce and access challenges so that we can continue telling the story of home-based care's critical role in Oregon's healthcare system.