A study of the economic impact of Pennsylvania's home health care industry shows the sector is exerting a big footprint that's only expected to grow.

The report, commissioned by the Pennsylvania Homecare Association, found the home-based health care industry contributed nearly $22 billion in economic activity in the commonwealth last year - putting the sector just behind the state's medical schools and nursing homes in spending and jobs supported.

That economic activity tends to stay within the commonwealth's borders, said Paul Umbach, president of Tripp Umbach, the research firm behind the study.

"The nature of the industry is driven mostly by people providing the care within the homes of people in Pennsylvania so the workforce is almost entirely Pennsylvanian," he said.

The report also found that just over half of the home health agencies are accredited as adhering to standards higher than state regulations.

Umbach said it's impressive so many agencies have been accredited at all, since it's a relatively new and non-required standard.

The Pennsylvania Homecare Association represents about 500 home care and hospice providers.