Penn LDI flags caregiving shortfall

The University of Pennsylvania’s Leonard Davis Institute of Health Economics said on May 13 that an aging population, workforce strain and federal debt are converging on the U.S. health system, with one of the clearest pressure points in home and community-based care. At Penn’s Population Aging Research Center annual retreat, researchers focused on the growing gap between the number of older Americans who will need help and the number of workers available to provide it. Bianca K. Frogner, a professor at the University of Washington School of Medicine, said the shortage is structural rather than temporary, centered on direct-care jobs that have long been marked by low wages and high turnover. The discussion came as federal labor data show home health and personal care aides are projected to be one of the country’s fastest-growing occupations over the next decade. ### Who raised the warning at Penn’s aging retreat? Bianca K. Frogner delivered the keynote at the 2026 Penn Population Aging Research Center retreat, according to Penn’s May 13 account of the event. Penn identified Frogner as director of the Center for Health Workforce Studies at the University of Washington School of Medicine and said she warned that the nation’s aging population is driving demand for home health aides, nursing assistants and other long-term care workers. (ldi.upenn.edu) Penn’s report said Frogner tied that demand to persistent job conditions in direct care, including low wages, high turnover and limited support systems. In Penn’s account, she urged policymakers and health systems to treat the shortage as a long-run workforce constraint across home and community settings. (ldi.upenn.edu) ### How big is the workforce demand Penn is pointing to? The U.S. Bureau of Labor Statistics projects employment of home health and personal care aides to grow 17% from 2024 to 2034. The agency says that would make the occupation much faster growing than the average for all jobs, with about 765,800 openings projected each year on average over the decade. (ldi.upenn.edu) BLS also lists home health and personal care aides among the occupations expected to add the most jobs, projecting 739,800 new positions from 2024 to 2034. The agency reported a median annual wage of $34,900 for the occupation in May 2024. ### Why does aging make the shortage harder to solve? The Census Bureau has projected that by 2030 all baby boomers will be age 65 or older, pushing one in five Americans into retirement age. (bls.gov) Census researchers also projected that by 2034 older adults will outnumber children for the first time in U.S. history. Penn’s retreat summary said that demographic shift is colliding with a care model that increasingly depends on workers who help people remain at home or in community settings rather than institutions. (bls.gov) That is the setting where Frogner said shortages are already visible and where Penn said planners should not assume professional care will be easy to find. (census.gov) ### What does this mean for home and community-based care programs? A Penn LDI research update from 2023 said more than 9 million people use long-term services and supports each year in the United States and that care is increasingly delivered through home- and community-based services, with 66% funded by Medicaid. The same Penn summary, citing Health Affairs research by Amanda Kreider and Rachel M. Werner, said the number of home care workers failed to keep pace with enrollment in Medicaid-funded home- and community-based services programs between 2008 and 2020. (ldi.upenn.edu) That earlier Penn work gives context to the retreat’s warning. Rather than assuming that formal caregivers will be available when demand rises, the Penn discussion pointed toward planning around scarcity in the direct-care labor pool. ### Where does federal debt enter the discussion? (ldi.upenn.edu) Kent Smetters, a professor at the Wharton School, was listed by Penn as a keynote speaker alongside Frogner at the May 2026 retreat. Penn said the event examined how federal debt, along with aging and workforce strain, is reshaping health care for older Americans. (ldi.upenn.edu) Penn’s public write-up did not attach a single new debt estimate to the caregiving warning, but it framed fiscal pressure as part of the policy environment facing programs that serve older adults. That places the workforce shortage inside a broader budget debate over how the United States will finance care as the older population grows. (ldi.upenn.edu) ### What comes next after the Penn event? The Leonard Davis Institute published the retreat account on May 13 and identified the event as the 2026 annual retreat of Penn’s Population Aging Research Center. Penn’s PARC page says the center was established in 1994 with a grant from the National Institute on Aging and continues to publish research and event updates through the institute’s website. (ldi.upenn.edu) The next public step is likely to come through Penn LDI’s research updates and related PARC publications, where the institute posts speaker summaries, charts and follow-up analysis from its aging research events. (ldi.upenn.edu 1) (ldi.upenn.edu 2)