Nursing care and continuing care retirement communities (CCRCs) saw spending grow 9.5% in 2023, the highest it’s been since a big Covid-year surge in 2020 of 11.8%.

The space experienced a bit of whiplash between 2020 and 2023, dropping to negative 6.4% growth in 2021 and then 5.9% growth in 2022, according to the national health expenditures report for 2023, published by Health Affairs and compiled by officials at the Centers for Medicare & Medicaid Services (CMS).

The industry reported $211.3 billion in expenditures for 2023, an increase compared to $192.9 billion in 2022 and $182.2 billion in 2021. Expenditures exceeded 2020 spending, which was $194.7 billion.

Other long-term care categories including home health saw 10.8% annual growth in 2023, matching its growth in 2020. Home health had a steadily rising percentage since a low of 0.4% in 2021 but never dropped into the negative like skilled nursing. It should be noted that skilled nursing didn’t return to Covid-era growth, something home health was able to achieve, according to the Health Affairs report.

Health care spending overall in the country reached $4.9 trillion and increased 7.5% in 2023, growing from a rate of 4.6% in 2022.

“Although there is uncertainty about the future, expectations are that the traditional economic and demographic drivers of health spending will lead to the return of health care accounting for a larger share of the economy,” researchers said.