America Can’t Modernize Healthcare Without Modernizing our Caregiver Infrastructure

Every major transformation in U.S. healthcare over the past decade has revolved around one persistent theme: shifting more care into the home. From hospital-at-home programs to virtual visits, remote patient monitoring, and post-acute navigation, the industry has embraced care models that rely on patients recovering where they live.

What has been overlooked is that 63 million Americans, nearly one in four adults, are already providing that care every day, often without any training, compensation or support. According to recently released data from AARP and the National Alliance for Caregiving (NAC), the number of family caregivers has surged by 20 million in just ten years; becoming one of the largest workforces in the country.

Yet as healthcare continues to innovate, caregivers rarely appear in investor decks, benefit design, workflow mapping, or technology roadmaps. 

If the shift toward home-centered care continues, the industry faces a critical inflection point: caregiver infrastructure must become core healthcare infrastructure.

A Crisis Hiding in Plain Sight

The national data paints a picture of an overstretched system depending on overstretched and unpaid family caregivers:

• Nearly 1 in 4 provide 40+ hours of care per week, effectively adding another full-time job to their lives.
• One-third are “sandwich generation” caregivers, simultaneously raising children and caring for an adult loved one
• Nearly 50% report significant financial strain, including debt, reduced savings, or difficulty affording basic needs.

These pressures ripple outward, affecting quality of care, recovery timelines, avoidable utilization, employer productivity, and broader population health outcomes. Caregivers are not a side story; they are a structural determinant of healthcare performance.

Healthcare Wasn’t Designed for Continuous Care

Hospital systems, payers, and digital health innovators have made significant strides in improving episodic care. But caregiving isn’t episodic, it is continuous, often stretching across months, years, or decades.

This mismatch creates four systemic failures:

1. Fragmentation: Caregivers operate outside clinical workflows, leaving critical information gaps between families and care teams.
2. Access barriers: Navigating home-care agencies, vetting providers, coordinating schedules, and securing respite support falls entirely on families.
3. Equity gaps: The burden disproportionately affects lower-income, rural, Black and Latino caregivers.
4. Hidden costs: Employers incur turnover, absenteeism, and productivity losses; health systems face preventable readmissions; payers absorb downstream complications that could have been mitigated earlier.

In other words: caregivers are performing essential healthcare functions within a system that does not recognize them as part of the care team.

A Glimpse Into the Unseen Workforce

I have lived these gaps personally. As a daughter, a mother, and a patient. 

When I became my mother’s long-distance caregiver and later her court-appointed conservator, I navigated everything from dementia to elder manipulation to medical and legal complexities. I cared for a premature newborn weighing just three pounds, without local support. I managed post-surgical recovery with limited help at home.

These were uniquely different phases of my life, yet the experience followed the same pattern: limited guidance, fragmented resources, and no straightforward way to get assistance when I needed it most.

Being a caregiver is both rewarding and challenging, and is what ultimately led me to build solutions in this space.

Why Caregiver Infrastructure Must Become a Strategic Priority

As health systems, employers, and innovators accelerate home-based care, caregiver support must be embedded into the core of healthcare design.

This means:

1. Integrating caregivers into clinical workflows: Caregivers should be recognized as part of the care team, with appropriate data access, training, and communication channels.
2. Expanding employer caregiver benefits: With 60% of caregivers also employed, caregiving-support programs reduce turnover and absenteeism while improving worker health.
3. Leveraging marketplaces and tech platforms to expand capacity: Centralized ecosystems can simplify access to vetted, reliable respite services—reducing friction and improving continuity of care.
4. Applying data science to understand caregiver strain: Caregiving trends are predictive of patient risk, cost escalations, and care gaps. It’s time to analyze them as such.
5. Treating respite as a healthcare intervention: A caregiver who is exhausted, isolated, or in poor health cannot sustain safe, effective care. Caregiver relief isn’t a luxury; it is preventive health care.

Digital health has transformed diagnostics, prescribing, maternal care, behavioral health, and chronic disease management. But if innovation continues ignoring the unseen workforce enabling home-based care, the system will remain fundamentally unstable.