Elder Care Services in the US by Service, Provider, Payment Source and Region, 4th Edition

Report Overview

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Baby Boomers & Their Desire to Age in Place Will Shape Elder Care Market

US elder care revenues are projected to reach $388 billion in 2021. Gains will be supported by a variety of factors, including:

• an aging population, particularly as the large baby boomer demographic advances into age cohorts that require a greater level of care
• increasing cost of care
• continued desire among older adults to age in place and contract for the professional services that enable them to do so
• reduced stigma attached to receiving care, especially among males

Key Findings in the Elder Care Services Study:

Consumer Concerns Regarding Aging Will Continue to Shape Elder Care Market

Several consumer preferences and concerns are helping to shape the elder care market:

• The majority of consumers prefer to age in place, propelling gains in home-based services (e.g., home healthcare and social services).
• Many consumers are concerned about relying on and burdening their families as they age, which drives them to utilize professional care services.
• Concerns regarding accumulated financial resources and long-term access to Medicare and Medicaid differ across age groups and further impact expectations for elder care services.

Assisted Living, Social Services Supported by Lower Cost of Assistance with ADLs

Skilled nursing will remain the largest elder care service segment, but gains will be below the market average. The high cost of this care-intensive service, coupled with the need to uproot older adults from their homes, will continue to draw customers to community-based options. This will benefit the smaller social services and assisted living segments, which will see the fastest gains through 2021. Although care is limited to socialization and help with the activities of daily living (ADLs), these services are favored because:

• they have lower costs relative to skilled nursing
• they provide levels of care that are tailored to an individual’s needs
• they offer greater independence for older adults but still provide the care needed to keep them safe

The relatively limited, though growing, coverage for assisted living and social services will restrain gains for these segments.

Out-of-Pocket and Private Insurance Payments to See Fastest Growth as Cost of Care Rises

Government payment sources are vital to this industry, with Medicaid and Medicare together paying for over half of market revenues in 2016. Both have seen limited gains due to reduced reimbursement rates, but expanded coverage via the ACA supported growth.

Payments from private insurance and out-of-pocket will see above average growth, driven by rising interest in community-based services that have limited coverage from government funding sources.

Study Coverage

This industry study presents historical demand data (2006, 2011 and 2016) and forecasts for 2021 by service (skilled nursing, home healthcare, social services, continuing care retirement communities, assisted living), provider (for-profit, nonprofit), payment source (Medicaid, out-of-pocket, Medicare, private insurance), and region. The study also evaluates company market share and analyzes industry competitors including Amedisys, Brookdale Senior Living, Genesis HealthCare, HCR ManorCare, Kindred Healthcare, Life Care Centers of America, SavaSeniorCare, and Sunrise Senior Living.

US elder care revenues are projected to increase 4.8% annually through 2021 to $388 billion, supported by a variety of factors, including: an aging population; increasing cost of care; continued desire among older adults to age in place; and reduced stigma attached to receiving care. Skilled nursing will remain the largest elder care service segment, but gains will be below the market average. The high cost of this service, coupled with the need to uproot older adults from their homes, will continue to draw customers to community-based options, benefiting the smaller social services and assisted living segments, which will see the fastest gains through 2021.

This study analyzes the US market for elder care services. Services covered include:

• skilled nursing facilities
• home healthcare services
• social services
• continuing care retirement communities
• assisted living facilities

Excluded from the study are services provided by caregivers who are directly employed by the patient or family and care that is provided by the family members themselves.

Both nonprofit and for-profit providers play important roles in the elder care services market. For the purposes of this study, nonprofit organizations include:

• independent charitable 501(c)(3) groups
• organizations affiliated with not-for-profit hospitals and government-supported agencies
• all other organizations operating on a not-for-profit basis

Conversely, for-profit entities include all conventionally run businesses that distribute profits to owners and stakeholders, whether the company is publicly traded or privately held.

This study also includes regional and payment source analysis. The primary payment sources for elder care services include:

• Medicaid
• Medicare
• out-of-pocket payments
• private insurance

Other sources include the Department of Veterans Affairs, private grants, and charitable donations.