The Growing Role of the Home Health Nurse

More than 56 million Americans, roughly 17% of the total population, are 65 and older, according to the latest data from the U.S. Census Bureau. As baby boomers age, that population will continue to grow, reaching 73 million by 2030 — more than 20% of the population.

As individuals age, their medical needs tend to grow and become more complex. Home health care can be a lifeline for many people, particularly those who find it hard to go to clinics or hospitals for treatment. Home health nurses and other providers work one-on-one with patients in their homes, providing the necessary medical care and support to help them stay healthy and independent.

Although home health nurses work with a variety of patient populations, the rising number of older Americans has contributed to greater demand for these health care professionals. According to the Centers for Medicare and Medicaid Services, more than 5 million Medicare beneficiaries received home health care in 2019 — a number that rose during the COVID-19 pandemic.

The recent and continued growth in home health care creates opportunities for those who want to enter this rewarding field.

Beyond building a strong foundation for nursing positions in hospitals and clinics, an advanced nursing education can also prepare graduates for home health nursing roles.

What Is Home Health Nursing?

In the specialized field of home health nursing, nurses provide medical care and support to patients in their own homes. Home health nurses work with patients of all ages, from infants to the elderly, including those who may be disabled, critically ill, recovering from surgery or injury, or in need of ongoing medical care. Although various patient populations may receive home health care, adults over 65 represent the majority of patients receiving home health care in the U.S.

One of the primary goals of home health nursing is to deliver health care services to patients in a comfortable and familiar environment, with the same level of care they’d receive in a medical facility. This allows patients to maintain their independence and dignity while receiving the medical care they need. Home health nurses offer a wide range of services, including:

Wound care
Medication management
Dialysis
IV therapy
Pain management

Home health nurses can specialize in certain types of care or working with specific patient populations. For example, they may provide support to pregnant mothers and new parents, assisting with breastfeeding, newborn care, and postpartum recovery.

They also play a critical role in educating patients and their families on how to manage their conditions and maintain their health. This can include providing information on:

Healthy lifestyle choices
Nutrition
Exercise
Stress management

In addition to medical care, home health nurses also provide emotional and social support to patients and families. They may offer encouragement and provide information on community resources that can assist with ongoing care.

The Need for Home Health Nurses

The home health care market has experienced significant growth in recent years, partly due to shifts in care triggered by the COVID-19 pandemic. According to Grand View Research, the U.S. home health care market experienced 7% growth between 2020 and 2021, reaching a value of nearly $133 billion in 2021.

Globally, the home health care market is projected to grow even further over the next several years, expanding at a compound annual growth rate of nearly 8% from 2023 to 2030.

Several factors have contributed to the rise in home health care and the growing need for professionals, such as home health nurses, who can administer this care.

Advances in Medical Technology

Technological advances in health care have been a boon to home health nurses, equipping them with the tools they need to deliver high-quality care in their patients’ homes. One of the biggest advancements has been the development of portable medical equipment, which allows nurses to bring the same level of care found in hospitals and clinics to their patients’ homes.

For example, advances in wound care technology have enabled home health nurses to provide advanced wound care treatments, such as negative pressure wound therapy, without the need for hospitalization. Portable electronic devices such as glucose monitors, blood pressure monitors, and pulse oximeters also allow nurses to easily monitor patient health status and adjust treatment plans as needed.

Telehealth technology has also been a game-changer for home health nursing. With the use of videoconferencing and other communication tools, nurses can consult with physicians and other health care professionals in real time, making it easier to provide coordinated and comprehensive care to patients. This technology also allows nurses to remotely monitor patient health status and provide virtual support and education.

Cost-Effective Care

Home health nursing has been shown to be more cost-effective than traditional nursing in a hospital setting for several reasons. For one thing, hospitals have significantly higher overhead costs — including staffing, equipment, and maintenance expenses — which often get passed down to patients. By contrast, home health care requires far less infrastructure, which can result in lower costs for patients and health care systems.

Additionally, Medicare covers many home health services. With the population of 65-and-over, Medicare-eligible adults projected to grow significantly in the coming decades, demand for home health care is also expected to rise. And since Medicare reimbursements often favor value-based care — which promotes improved patient outcomes while keeping costs under control — home health care has grown into a popular treatment modality. Industry experts also anticipate that regulatory changes will lead to higher Medicare reimbursements for home health care, causing more patients to opt for this service.

The improved health outcomes associated with home health care can also result in long-term cost savings. By administering personalized care and support, home health nurses can help patients to manage their chronic conditions, improve their overall health, and reduce their risk of complications. This can lead to fewer emergency department visits, hospitalizations, and other costly medical interventions over time.

Reduced Hospital Remissions

Home health care can help to reduce the likelihood of hospital readmissions, a major expense for health care systems. By providing patients with the necessary care and support in their homes, home health nurses can help prevent complications and ensure that patients are able to recover more quickly. This can help to reduce the need for additional hospital stays and procedures, which can be costly for both patients and health care providers.

Increased Demand for Chronic Care Management

The growing demand for chronic care management has also boosted demand for home health nurses. Chronic diseases such as diabetes, heart disease, and respiratory conditions require ongoing treatment, and many patients prefer to receive this care in the comfort of their own homes. Home health nurses are uniquely positioned to administer this type of care, as they can monitor patients’ health status, provide education and support, and adjust treatment plans as needed.

Changes in health care policy have also contributed to the increased demand for home health nursing. For example, the Affordable Care Act has placed greater emphasis on preventive care and chronic disease management, which has led to an increased demand for home health services.

Aging Population and Aging in Place

The aging population in the United States has also contributed to the increased demand for chronic care management and home health care.

As people age, they are more likely to develop chronic conditions that require ongoing care and management. Home health nurses can help older adults manage their chronic conditions, maintain their independence, and avoid unnecessary hospitalizations and medical interventions.

Additionally, most older adults prefer to remain in their homes as they age, a concept known as “aging in place.” According to the 2022 National Poll on Healthy Aging, 88% of people polled between the ages of 50 and 80 said it was important for them to live in their homes as long as possible.

For many older adults and their families, aging in place requires home modifications (such as ramps, grab bars, and shower chairs or benches) and additional social support from others. Despite most older adults preferring to age in place, only 15% of individuals polled had given a lot of consideration to home modifications for older adult living, and 48% of those who lived alone reported not having someone in their lives who could help them with personal care tasks, such as bathing or dressing.

As the population continues to age and the health care system shifts toward a preventive and patient-centered approach, the demand for home health nursing is expected to continue to grow.

Home Health Nurse Responsibilities

The job description of home health nurses may vary depending on their specialization and training and the patient populations they work with. Some common responsibilities of home health nurses include:

Assessing patient needs and developing a treatment in collaboration with other providers
Monitoring vital signs
Administering medication
Managing wound care
Providing care for chronic diseases and conditions such as amyotrophic lateral sclerosis (ALS), multiple sclerosis (MS), spinal cord injury, and traumatic brain injury
Using and maintaining the proper functioning of medical devices such as catheters, ventilators, and feeding tubes
Assisting with activities of daily living (ADLs) such as toileting, bathing, or personal grooming
Documenting patient care
Providing medical education to patients and families

Home Health Nursing: Pros and Cons

In addition to the benefits to patients, home health care also has numerous advantages for nurses, such as:

Increased autonomy: Home health nurses often have a greater degree of autonomy than traditional nurses, as they work more independently and make many clinical decisions on their own.
Strong patient relationships: Working in patients’ homes allows nurses to develop strong relationships with their patients, providing emotional support and developing a deeper understanding of their needs. By interacting with and observing patients in their own homes, nurses may also have greater insight into the environmental factors that contribute to their patient’s overall health and well-being, such as safe and sanitary living conditions or assistive technology.
Flexible schedule: Because home health nurses generally work through an agency, as opposed to a facility, they can often choose their own schedules. This affords them greater flexibility and can make it easier for them to balance their work and personal responsibilities.
Reduced exposure to infection: Unlike nurses who work in hospitals and clinics, home health nurses are not exposed to a high volume of infectious diseases and are therefore at lower risk of contracting infections.

Although there are many perks of home health nursing, it has some drawbacks as well, such as:

Added paperwork and documentation: Home health nurses are responsible for a significant amount of paperwork and documentation that would otherwise be shared by administrative staff at a hospital or clinic, which can be time-consuming and tedious.
Variable working conditions: Working in patients’ homes can present a range of challenging working conditions, including limited space and poor lighting.
Potential safety risks: Nurses providing home care may encounter safety risks, such as aggressive pets, unsafe neighborhoods, and unstable patients.
Emotionally demanding work: Providing care in patients’ homes can be emotionally demanding; home health nurses may encounter patients and families who are struggling with serious illnesses or other difficult circumstances.

How to Become a Home Health Nurse

The recent growth of home health care and its promising future provide many opportunities for nurses seeking a career in this emerging sector. The path to becoming a home health nurse is similar to that of many other nursing roles, with a foundation in education.

The following are common steps individuals can take to qualify for home health nursing roles:

Earn a foundational nursing degree. A Bachelor of Science in Nursing (BSN) is a four-year nursing program that provides education in nursing theory, research, and leadership. BSN programs also provide clinical experience in a variety of health care settings, preparing graduates to take the NCLEX-RN exam and become licensed registered nurses (RN).
Attain a nursing license. Home health nurses must be licensed as an RN in the state where they practice.
Earn an advanced nursing degree. Earning a graduate degree in nursing, such as a Master of Science in Nursing (MSN), prepares graduates for advanced nursing roles, including nurse practitioner and clinical nurse specialist. Though an advanced degree may not be required for many home health nursing roles, it can help job seekers stand out to potential employers. Also, graduate programs typically offer students the opportunity to focus on a particular type of care, which can help them land a specialist role in home health care.
Certification. While certification typically isn’t required for home health nurses, it demonstrates expertise in this field and may help candidates boost their job prospects. The American Nurses Credentialing Center’s Home Health Nursing Certification (RN-BC) is one such credential.
Gain employment through a home health agency. Home health agencies are organizations that provide home health services to patients. These agencies often hire home health nurses to provide care to patients in their homes. Staffing agencies can also help nurses find temporary or permanent positions with health care organizations and negotiate contracts and salaries.

Prepare to Care for Patients in Their Homes

Due to an array of factors, home health care is on the rise. As a result, home health nurses are increasingly in demand, a trend that is likely to continue as the 65-and-older population grows.

Regis College’s online Master of Science in Nursing program can help prepare you for a role in this emerging sector. The program, featuring two concentrations in adult gerontology (acute care and primary care), is designed to equip graduates with the skills and expertise they need for a host of leadership and specialist roles.

Discover how Regis can prepare you for a rewarding career in nursing today.