A new report from AARP is shining a spotlight on one of the most overlooked forces in American healthcare: family caregivers.
The report, Exploring Utilization and Advancing Impact of Caregiver Training Services, examines the early rollout of Medicare’s new Caregiver Training Services reimbursement codes — a policy change that could significantly reshape how providers, including home care agencies, engage with families.
For home care agency owners, the report is more than policy analysis. It is a roadmap pointing toward where senior care is heading: a future where agencies that successfully educate, support, and collaborate with family caregivers may gain a major competitive advantage.
Family Caregivers Are the Backbone of Care
The backdrop to the report is staggering.
According to AARP and the National Alliance for Caregiving, roughly 63 million Americans now serve as family caregivers — nearly one in four adults.
These caregivers are increasingly handling complex responsibilities once reserved for clinicians, including medication management, wound care, mobility assistance, injections, feeding tubes, and dementia-related behavioral support.
Yet despite the growing complexity of care delivered in the home, training remains rare. AARP data cited across several caregiving studies shows only a small percentage of caregivers receive formal instruction.
That gap is precisely what Medicare’s new CTS codes were designed to address.
Beginning in 2024, the Centers for Medicare & Medicaid Services introduced billing codes that allow healthcare providers to be reimbursed for structured caregiver education and training.
The services can include instruction related to:
- Medication administration.
- Infection prevention.
- Mobility and transfers.
- Chronic disease management.
- Dementia care.
- Use of medical equipment.
- Activities of daily living support.
The concept is straightforward: better-trained caregivers can help patients remain safer at home, avoid hospitalizations, reduce complications, and improve overall outcomes.
Early Adoption Has Been Slow
The AARP report found that utilization of the new CTS codes remains limited so far.
Researchers noted that many providers are still unfamiliar with the codes, uncertain about documentation requirements, or unclear about workflow integration.
That is not unusual for newly introduced Medicare reimbursement pathways. Still, the report argues that the slow adoption reflects larger structural problems within healthcare.
Among the major barriers identified:
- Lack of provider awareness.
- Operational complexity.
- Limited workflow integration.
- Insufficient staffing capacity.
- Unclear payer guidance.
- Weak financial incentives.
AARP identified five key “enablers” necessary to increase adoption:
- Clear guidance and communication.
- Open access.
- Aligned incentives.
- Integrated infrastructure.
- Provider capacity.
For home care agencies, those findings matter because they reveal where the market may evolve over the next several years.
Why This Matters to Home Care Agencies
Historically, many home care agencies have focused primarily on the client receiving services. But the report reinforces a growing reality: agencies increasingly need to support the entire caregiving ecosystem, including spouses, adult children, and other unpaid caregivers.
That shift has both operational and strategic implications.
Family Caregivers Are Already Part of the Care Team
The report repeatedly emphasizes that family caregivers should no longer be viewed as informal helpers operating outside the healthcare system. Instead, they are central members of the care team.
Home care agencies understand this firsthand.
In many cases, agency caregivers may only be in the home for several hours per day, while family members provide the remaining care coverage. The quality of communication and coordination between paid caregivers and family caregivers can directly affect outcomes.
Agencies that proactively train and educate families may see:
- Fewer avoidable emergencies.
- Reduced caregiver burnout.
- Improved client retention.
- Better care continuity.
- Stronger family satisfaction scores.
In other words, caregiver education is not simply a clinical add-on. It may become a core business differentiator.
Dementia Care May Be Especially Impacted
One of the clearest implications of the report involves dementia care.
Families caring for loved ones with Alzheimer’s disease or other dementias often struggle with behavioral symptoms, wandering, communication challenges, medication adherence, and caregiver stress. Many feel unprepared for the progression of the disease.
At the same time, dementia-related demand is surging nationwide.
Home care agencies that develop structured caregiver coaching programs around dementia could find themselves particularly well-positioned as reimbursement pathways evolve.
That could include:
- Caregiver coaching sessions.
- Fall prevention instruction.
- Transfer and mobility training.
- Behavioral de-escalation education.
- Medication management guidance.
- Respite planning support.
Some agencies are already moving in this direction by integrating caregiver education into care plans, even outside formal Medicare reimbursement structures.
The AARP report suggests those efforts may increasingly align with broader healthcare policy trends.
Agencies May Need Stronger Clinical Infrastructure
Another important takeaway is that caregiver training programs require infrastructure.
The report notes that successful implementation depends heavily on workflow integration, staffing models, and interdisciplinary coordination.
For many non-medical home care agencies, that raises important questions.
Should agencies:
- Partner more closely with healthcare systems?
- Expand nurse oversight?
- Build educational content libraries?
- Create caregiver onboarding programs?
- Invest in digital caregiver support platforms?
The answers will likely vary by agency size and market position. But the broader direction appears clear: education and caregiver support are becoming increasingly valuable service lines.
Caregiver Burnout Is Becoming a Public Health Crisis
The report also intersects with broader caregiving trends that continue to intensify nationwide.
Recent AARP findings show:
- More than 40% of caregivers now provide high-intensity care.
- Many spend over 20 to 40 hours weekly caregiving.
- Financial strain and emotional stress are widespread.
- Many caregivers report declining personal health.
Meanwhile, the estimated economic value of unpaid caregiving now exceeds $1 trillion annually.
For home care agencies, caregiver burnout represents both a humanitarian issue and a market reality.
Families under severe stress are more likely to seek outside support. But they also need guidance navigating care systems, understanding disease progression, and managing expectations.
Agencies that position themselves as trusted educator-partners — not merely staffing providers — may gain stronger long-term relationships with clients and referral sources alike.
The Industry Is Moving Toward Collaborative Care
Perhaps the biggest message from the AARP report is that healthcare is slowly beginning to formally recognize family caregivers as essential infrastructure.
That recognition has major implications for home care.
As value-based care models expand, hospitals, physician groups, Medicare Advantage plans, and home-based care providers will likely face growing pressure to improve outcomes while reducing unnecessary utilization.
Well-trained family caregivers can help accomplish both goals.
The agencies most prepared for this shift may be those that:
- Build formal caregiver engagement strategies.
- Develop educational resources.
- Strengthen clinical collaboration.
- Integrate family communication into workflows.
- Embrace caregiver support as part of their mission.
The AARP report stops short of predicting widespread adoption of caregiver training reimbursement in the near term. But it makes one point abundantly clear: the healthcare system increasingly understands that family caregivers cannot continue carrying enormous responsibilities without meaningful support.
For home care agencies, that evolving recognition may create one of the industry’s most important opportunities of the next decade.
