UNDERSTANDING AI By Sima Ladjevardian Care is infrastructure: It’s time to build it accordingly AI can solve a slow-motion crisis hiding in plain sight: the businesses that make the rest of the economy run are barely breaking even. Somewhere in America right now, a home health agency owner is trying to fill a last-minute shift for an 84-year-old client who cannot be left alone. She is texting caregivers one by one, manually, from a list she keeps in a notes app. Across town, a woman running a family services organization is three hours into paperwork that documents a single intake appointment. And not far from either of them, a childcare center director is fielding the same enrollment question she has answered a hundred times this month because the answer lives in a spreadsheet only she knows how to read. These women are not behind the times. They are all running critical public infrastructure that the U.S. economy cannot function without and doing it almost entirely alone. The invisible on-ramp Ask most policymakers what enables economic participation and they’ll describe roads, broadband, ports. They’re not wrong. But there’s another category of infrastructure that makes it possible for millions of people—disproportionately, women—to show up, clock in, and build: care. Childcare, elder care, home health services: these are the invisible on-ramps of the American economy. Women own the majority of these businesses. And despite their importance—and the significant cost to users—they operate under conditions that would stress-test any owner: thin margins, heavy regulation, perpetual staffing challenges, and administrative complexity that could bury a mid-size law firm. The numbers are stark. For example, daycare centers’ net profit margins run at less than 1%, according to research cited by experts like the Bipartisan Policy Center and Federal Reserve Bank of Minneapolis. That leaves almost no slack in the system. An unexpected inspection, a staff member out sick, a burst pipe: any of these can tip a center from barely profitable to a month behind on rent. The cruelty of the situation is that demand is not the problem. The U.S. childcare market was valued at $65 billion in 2024 and is projected to reach nearly $110 billion by 2033 according to Grand View Research. The home healthcare market is estimated at $162 billion and may exceed $380 billion by 2033. These are not struggling backwater industries. They are some of the most reliably needed services in the economy: growing fast, structurally underfunded, and quietly essential to everything else. The International Labour Organization estimates that every dollar invested in the care economy returns $3.76 in global GDP and yet the sector remains chronically underfinanced and underbuilt. A real opportunity in the margins In 2026, AI is doing what the internet did in the 1990s: upending the fundamental cost structure of building and running a business. Tasks that once required teams of developers and enormous budgets can now be done by a motivated nontechnologist with a few free hours. That’s a transformative force, and for care businesses operating on sub-1-percent margins, it’s not merely convenient. It could be the difference between closing and staying open. Early evidence is already promising. Care management software can reduce administrative time meaningfully: one documented case study from the firm Technavio showed reductions in billing errors of around 15% and savings of approximately 10 hours per week in administrative tasks. Another widely cited industry estimate from software provider Procare Solutions suggests childcare centers can reclaim 60 to 80 hours per month across tasks that include billing, payroll, attendance tracking, and parent communication. AI can and has been applied to anticipating care needs, matching caregivers to clients, bridging linguistic divides, and transcribing notes and updates. Many of these uses enable each caregiver to serve more people per shift. For a director who is also the lead teacher, the HR department, the compliance officer, and the head of marketing, the time saved could radically improve business viability. The design gap nobody Is talking about But those adoption gains belong mostly to larger, better-resourced operations. The independent owner-operator—the woman running a single childcare center or a small home health agency—is largely not yet benefitting. This is often framed as a training problem or a motivation problem. It is neither. It is a design problem. AI and digital innovation efforts have focused heavily on hospitals, large health systems, and institutional payers. The tools that do exist for care settings tend to address discrete administrative tasks: one tool for billing, another for scheduling, rather than the integrated, growthoriented functionality that a solo operator actually needs. An owner trying to decide whether she has the capacity to take five more enterprising Women 31 Salomi art / Shutterstock.com
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