Nursing Homes Led in Wage Growth, Service Price, While Job Creation Slowed in December

The nursing home industry led the health care sector in wage growth while prices for skilled nursing services grew at the fastest pace at the end of 2023. Meanwhile, employment growth slowed to a crawl in December despite a desperate need to bolster the nursing home workforce. 

This is according to Altarum’s Health Sector Economic Indicators (HSEI) briefs released Friday, which also shows that nursing homes added 4,700 jobs in December, while other nursing and residential care settings lost 1,500 jobs that same month. Considering losses in these other areas, the overall post-acute care space added 3,200 jobs in December, the nonprofit health care advisory firm said.

Employment growth in December was slow, the report found, but capped off a “historic year of job creation” in 2023. Altarum’s last HSEI brief published in March saw a staggering 44,200 jobs added in February across all health care settings, with nursing and residential care facilities contributing 13,700 jobs to the monthly amount.


It’s worth noting that wage growth in the nursing home industry also grew at 4% year over year – health care wage growth in November was 2.9%, to put things in perspective, although the private sector saw 4% wage growth as well, the most recent Altarum report found.

Hospitals and ambulatory care saw the second and third largest wage growth numbers, increasing by 3.3% and 2.4% respectively.

Coupled with added jobs and wage growth, nursing home care was among service prices to grow the fastest by 4%. Dental pricing grew the most at 5% and home health care grew 4.2%. Physician and clinical services, meanwhile, saw the slowest price growth at 0.3%, according to the Altarum report.


Nursing home care monthly spending increased steadily between November 2021 and 2023, according to Altarum, rising from $187.7 billion in 2021 to $212.8 billion in 2023.

Nursing home utilization grew 4.1% on a 12-month moving average, the report found, and saw 3.2% growth on a 3-month moving average. For November only, nursing home utilization growth came in at 3.8%.

In terms of major payers, Medicaid price growth was the fastest in December at 3.8% year over year, followed by private insurance patients’ price growth at 3.4% and then Medicare patients’ price growth at 1.1%.

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