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

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

Elder Care Services

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.

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

    $5,200.00

    1. 1 EXECUTIVE SUMMARY

      $185.00

      1. Figure 1-1 | US Elder Care Services Market

    2. 2 OVERVIEW

      $1,480.00

      1. 2.1 Key Findings

        $82.00

        1. Figure 2-1 | Key Trends in the Elder Care Services Market

      2. 2.2 Consumer Trends in Elder Care Preferences

        $509.00

        1. 2.2.1 Concerns Regarding Elder Care Financing

          $213.00

          1. Figure 2-2 | Consumer Responses Regarding Elder Care Services Financing by Age, 2017

          2. Figure 2-3 | Consumer Responses Regarding Elder Care Services Financing by Race & Ethnicity, 2017

        2. 2.2.2 Preferences Regarding Family Elder Care

          $192.00

          1. Figure 2-4 | Consumer Responses Regarding Family Expectations for Elder Care Services by Age, 2017

          2. Figure 2-5 | Consumer Responses Regarding Family Expectations for Elder Care Services by Race & Ethnicity, 2017

        3. 2.2.3 Preferences Regarding Aging in Place

          $101.00

          1. Table | Consumer Responses by Age & Race & Ethnicity: "I prefer to age in place", 2017

      3. 2.3 Regulatory Environment

        $603.00

        1. 2.3.1 Overview

          $82.00

        2. 2.3.2 Affordable Care Act (ACA)

          $281.00

        3. 2.3.3 Anti-Kickback Statute

          $82.00

        4. 2.3.4 Occupational Safety & Health Administration (OSHA)

          $82.00

        5. 2.3.5 Consumer Protection

          $82.00

        6. 2.3.6 Improving Medicare Post-Acute Care Transformation Act (IMPACT Act)

          $82.00

        7. 2.3.7 Real Estate Investment Trust (REIT)

          $82.00

      4. 2.4 Employment

        $226.00

        1. 2.4.1 Employee Retention Concerns

          $151.00

        2. 2.4.2 Facility & Staff Licensing

          $82.00

      5. 2.5 Franchises

        $102.00

    3. 3 SERVICES

      $4,981.00

      1. 3.1 Key Findings

        $82.00

        1. Figure 3-1 | Elder Care Services Trends by Service Type

      2. 3.2 Revenues by Service

        $259.00

        1. 3.2.1 Types of Services

          $82.00

        2. 3.2.2 Revenues by Service: Revenues Forecast

          $232.00

          1. Table | Elder Care Services Revenue by Services Provider, 2006 – 2021

          2. Figure 3-2 | Elder Care Services Demand & CAGR by Type, 2016 – 2021

          3. Figure 3-3 | Elder Care Services Revenue Annual Growth, 2006 – 2016

      3. 3.3 Skilled Nursing

        $838.00

        1. 3.3.1 Skilled Nursing: Definition

          $82.00

        2. 3.3.2 Skilled Nursing: Revenue Forecast

          $174.00

          1. Table | Skilled Nursing Services Indicators, 2006 – 2021

          2. Figure 3-4 | Skilled Nursing Residents, Revenues, &Costs per Patient CAGR, 2011 – 2021

        3. 3.3.3 Skilled Nursing: Employees

          $125.00

        4. 3.3.4 Skilled Nursing: Regulations

          $152.00

          1. Table | Skilled Nursing Regulations

        5. 3.3.5 Skilled Nursing: Providers

          $123.00

          1. Table | Skilled Nursing Services Revenue by Provider Type, 2006 – 2021

        6. 3.3.6 Skilled Nursing: Payment Sources

          $227.00

          1. Table | Types of Government Coverage for Skilled Nursing Services

          2. Table | Skilled Nursing Services Revenues by Payment Source, 2006 – 2021

          3. Figure 3-5 | Skilled Nursing Services Demand & CAGR by Payment Source, 2016 – 2021

      4. 3.4 Home Healthcare Services

        $994.00

        1. 3.4.1 Home Healthcare: Definition

          $82.00

        2. 3.4.2 Home Healthcare: Revenue Forecast

          $193.00

          1. Table | Home Healthcare Services Indicators, 2006 – 2021

          2. Figure 3-6 | Home Healthcare Employment & Establishments CAGR, 2011 – 2021

        3. 3.4.3 Home Healthcare: Employees

          $110.00

        4. 3.4.4 Home Healthcare: Regulations

          $123.00

        5. 3.4.5 PERS Services

          $155.00

          1. Table | PERS Monitoring Services Overview, 2006 – 2021

        6. 3.4.6 Home Healthcare: Providers

          $137.00

          1. Table | Home Healthcare Services Revenues by Provider Type, 2006 – 2021

        7. 3.4.7 Home Healthcare: Payment Sources

          $196.00

          1. Table | Home Healthcare Services Revenues by Payment Source, 2006 – 2021

          2. Figure 3-7 | Home Healthcare Revenues & CAGR by Payment Source, 2016 – 2021

      5. 3.5 Social Services

        $1,177.00

        1. 3.5.1 Social Services: Definition

          $82.00

        2. 3.5.2 Social Services: Revenue Forecast

          $193.00

          1. Table | Social Services Indicators, 2006 – 2021

          2. Figure 3-8 | Social Services Employment & Establishments CAGR, 2011 – 2021

        3. 3.5.3 Social Services: Employees

          $213.00

          1. Table | Types of Social Services Caregivers

          2. Figure 3-9 | Social Services Caregivers by Type, 2016

        4. 3.5.4 Social Services: Service Types

          $369.00

          1. Table | Social & Medical Adult Day Care Models Characteristics & Services

        5. 3.5.5 Social Services: Providers

          $101.00

          1. Table | Social Services Revenue by Provider Type, 2006 – 2021

        6. 3.5.6 Social Services: Payment Sources

          $259.00

          1. Table | Social Services Coverage by Payment Source

          2. Table | Social Services Revenue by Payment Source, 2006 – 2021

          3. Figure 3-10 | Social Services Demand & CAGR by Payment Source, 2016 – 2021

      6. 3.6 Continuing Care Retirement Communities

        $973.00

        1. 3.6.1 Continuing Care Retirement Communities: Definition

          $82.00

        2. 3.6.2 Continuing Care Retirement Communities: Advantages & Disadvantages

          $266.00

          1. Table | Advantages & Disadvantages of Continuing Care Retirement Communities

        3. 3.6.3 Continuing Care Retirement Communities: Payment Options

          $136.00

          1. Table | Common Payment Options for Continuing Care Retirement Communities

        4. 3.6.4 Continuing Care Retirement Communities: Revenue Forecast

          $224.00

          1. Table | Continuing Care Retirement Communities Indicators, 2006 – 2021

          2. Figure 3-11 | Continuing Care Retirement Communities Residents, Revenues, &Costs per Patient CAGR, 2011 – 2021

        5. 3.6.5 Continuing Care Retirement Communities: Providers

          $159.00

          1. Table | Continuing Care Retirement Communities by Provider, 2006 – 2021

        6. 3.6.6 Continuing Care Retirement Communities: Payment Sources

          $136.00

          1. Table | Continuing Care Retirement Communities by Payment Source, 2006 – 2021

          2. Figure 3-12 | Continuing Care Retirement Communities Revenues & CAGR by Payment Source, 2016 – 2021

      7. 3.7 Assisted Living Facilities

        $694.00

        1. 3.7.1 Assisted Living Facilities: Definition

          $82.00

        2. 3.7.2 Assisted Living Facilities: Revenue Forecast

          $201.00

          1. Table | Assisted Living Facilities Indicators, 2006 – 2021

          2. Figure 3-13 | Assisted Living Residents, Residency, &Establishments CAGR, 2011 – 2021

        3. 3.7.3 Assisted Living Facilities: Employees

          $86.00

        4. 3.7.4 Assisted Living Facilities: Regulations

          $82.00

        5. 3.7.5 Assisted Living Facilities: Providers

          $152.00

          1. Table | Assisted Living Facilities Revenues by Provider, 2006 – 2021

        6. 3.7.6 Assisted Living Facilities: Payment Sources

          $148.00

          1. Table | Assisted Living Facilities Revenue by Payment Source, 2006 – 2021

          2. Figure 3-14 | Assisted Living Facilities Revenues & CAGR by Payment Source, 2016 – 2021

    4. 4 PROVIDERS

      $823.00

      1. 4.1 Key Findings

        $82.00

        1. Figure 4-1 | Elder Care Services Provider Trends

      2. 4.2 Revenues by Provider

        $171.00

        1. 4.2.1 Providers Definitions

          $82.00

        2. 4.2.2 Revenues by Provider: Forecast

          $136.00

          1. Table | Elder Care Services Revenues by Provider, 2006 – 2021

      3. 4.3 For-Profit

        $375.00

        1. 4.3.1 For-Profit: Revenue Forecast

          $157.00

          1. Table | For-Profit Elder Care Services Revenues by Service Type, 2006 – 2021

          2. Figure 4-2 | For-Profit Elder Care Services Demand & CAGR by Type, 2016 – 2021

        2. 4.3.2 For-Profit: Provider Characteristics

          $112.00

        3. 4.3.3 For-Profit: Regulations

          $106.00

      4. 4.4 Nonprofit

        $225.00

        1. 4.4.1 Nonprofit: Revenue Forecast

          $122.00

          1. Table | Nonprofit Elder Care Services Revenue by Service, 2006 – 2021

          2. Figure 4-3 | Nonprofit Elder Care Services Demand & CAGR by Type, 2016 – 2021

        2. 4.4.2 Nonprofit: Provider Characteristics

          $102.00

    5. 5 PAYMENT SOURCES

      $2,009.00

      1. 5.1 Key Findings

        $82.00

        1. Figure 5-1 | Trends in Elder Care Services Payment Sources

      2. 5.2 Revenues by Payment Source

        $169.00

        1. 5.2.1 Types of Payment Sources

          $82.00

        2. 5.2.2 Payment Sources: Outlook

          $152.00

          1. Table | Elder Care Services Revenues by Payment Source, 2006 – 2021

          2. Figure 5-2 | Elder Care Services Demand & CAGR by Payment Source, 2016 – 2021

      3. 5.3 Medicaid

        $394.00

        1. 5.3.1 Medicaid: Description

          $82.00

        2. 5.3.2 Medicaid: Key Program Trends

          $135.00

          1. Table | Selected Medicaid Statistics, 2006 – 2016

        3. 5.3.3 Medicaid: Payment Forecast

          $202.00

          1. Table | Medicaid Payments for Elder Care Services, 2006 – 2021

          2. Figure 5-3 | Medicaid Payments & CAGR by Service Type, 2016 – 2021

      4. 5.4 Out-of-Pocket

        $224.00

        1. 5.4.1 Out-of-Pocket: Description

          $82.00

        2. 5.4.2 Out-of-Pocket: Payment Forecast

          $197.00

          1. Table | Out-of-Pocket Payments for Elder Care Services, 2006 – 2021

          2. Figure 5-4 | Out-of-Pocket Payments & CAGR by Service Type, 2016 – 2021

      5. 5.5 Medicare

        $603.00

        1. 5.5.1 Medicare: Description

          $121.00

          1. Table | Medicare Types by Covered Services, Fees, &Availability

        2. 5.5.2 Medicare: Covered Services

          $167.00

          1. Table | Selected Medicare Statistics, 2006 – 2016

        3. 5.5.3 Medicare: Key Program Trends

          $168.00

        4. 5.5.4 Medicare: Payment Forecast

          $147.00

          1. Table | Medicare Payments for Elder Care Services, 2006 – 2021

          2. Figure 5-5 | Medicare Payments & CAGR by Service Type, 2016 – 2021

      6. 5.6 Private Insurance

        $340.00

        1. 5.6.1 Private Insurance: Key Coverage Trends

          $159.00

          1. Table | Selected Private Insurance Statistics, 2006 – 2015

        2. 5.6.2 Private Insurance: Payment Forecast

          $180.00

          1. Table | Private Insurance Payments for Elder Care Services, 2006 – 2021

          2. Figure 5-6 | Private Insurance Payments & CAGR by Service Type, 2016 – 2021

      7. 5.7 Other Payments

        $229.00

        1. 5.7.1 Other Payments: Description

          $82.00

        2. 5.7.2 Other Payments: Payment Forecast

          $168.00

          1. Table | Other Payment Sources for Elder Care Services, 2006 – 2021

          2. Figure 5-7 | Other Payments & CAGR by Service Type, 2016 – 2021

    6. 6 REGIONS

      $1,780.00

      1. 6.1 Key Findings

        $82.00

        1. Figure 6-1 | Elder Care Services Trends by Region

      2. 6.2 Regional Elder Care Services Revenues

        $146.00

        1. Table | Elder Care Services Revenues by Region, 2006 – 2021

        2. Figure 6-2 | Elder Care Services Revenue & CAGR by Region, 2006 – 2021

      3. 6.3 Northeast

        $328.00

        1. 6.3.1 Northeast: Revenue Forecast

          $118.00

          1. Table | Northeast: Elder Care Services Revenues by Source & Subregion, 2006 – 2021

        2. 6.3.2 New England

          $127.00

          1. Table | New England: Elder Care Services Revenues by State, 2006 – 2021

        3. 6.3.3 Middle Atlantic

          $82.00

          1. Table | Middle Atlantic: Elder Care Services Revenues by State, 2006 – 2021

      4. 6.4 Midwest

        $422.00

        1. 6.4.1 Midwest: Revenue Forecast

          $152.00

          1. Table | Midwest: Elder Care Services Revenues by Source & Subregion, 2006 – 2021

        2. 6.4.2 East North Central

          $122.00

          1. Table | East North Central: Elder Care Services Revenues by State, 2006 – 2021

        3. 6.4.3 West North Central

          $147.00

          1. Table | West North Central: Elder Care Services Revenues by State, 2006 – 2021

      5. 6.5 South

        $506.00

        1. 6.5.1 South: Revenue Forecast

          $132.00

          1. Table | South: Elder Care Services Revenues by Source & Subregion, 2006 – 2021

        2. 6.5.2 South Atlantic

          $134.00

          1. Table | South Atlantic: Elder Care Services Revenues by State, 2006 – 2021

        3. 6.5.3 East South Central

          $114.00

          1. Table | East South Central: Elder Care Services Revenues by State, 2006 – 2021

        4. 6.5.4 West South Central

          $125.00

          1. Table | West South Central: Elder Care Services Revenues by State, 2006 – 2021

      6. 6.6 West

        $335.00

        1. 6.6.1 West: Revenue Forecast

          $105.00

          1. Table | West: Elder Care Services Revenues by Source & Subregion, 2006 – 2021

        2. 6.6.2 Mountain

          $111.00

          1. Table | Mountain: Elder Care Services Revenues by State, 2006 – 2021

        3. 6.6.3 Pacific

          $119.00

          1. Table | Pacific: Elder Care Services Revenues by State, 2006 – 2021

    7. 7 INDUSTRY STRUCTURE

      $1,744.00

      1. 7.1 Key Findings & Industry Composition

        $183.00

        1. Table | Elder Care Services Sales by Company, 2016

      2. 7.2 Market Share

        $410.00

        1. Figure 7-1 | US Elder Care Services Market Share, 2016

        2. Figure 7-2 | Elder Care Service Market Leader: Leading Supplier

        3. Figure 7-3 | Elder Care Services Market Leader: Second Leading Supplier

        4. Figure 7-4 | Elder Care Services Market Leader: Third Leading Supplier

        5. Figure 7-5 | Elder Care Services Market Leader: Fourth Leading Supplier

        6. Figure 7-6 | Elder Care Services Market Leader: Fifth Leading Supplier

      3. 7.3 Competitive Strategies

        $286.00

        1. 7.3.1 Competitive Strategies: Overview

          $82.00

        2. 7.3.2 Low Cost Leadership

          $82.00

        3. 7.3.3 Service Differentiation

          $126.00

        4. 7.3.4 Market Segmentation

          $82.00

      4. 7.4 Marketing

        $169.00

        1. Table | Marketing Strategies Employed by Elder Care Services Providers

      5. 7.5 Mergers & Acquisitions

        $229.00

        1. Table | Selected Acquisitions & Divestitures

      6. 7.6 List of Industry Participants

        $466.00

    8. 8 APPENDIX

      $1,573.00

      1. 8.1 Scope

        $105.00

        1. Table | Study Scope: Elder Care Services

        2. Table | Relevant NAICS (2007) &SIC Codes

      2. 8.2 Methodology

        $82.00

      3. 8.3 Sources

        $82.00

      4. 8.4 Associations & Agencies

        $82.00

      5. 8.5 Related Freedonia Group Studies

        $82.00

      6. 8.6 Definitions

        $378.00

      7. 8.7 Abbreviations

        $82.00

        1. Table | Abbreviations & Acronyms Used in Study

      8. 8.8 Macroeconomic Assumptions

        $316.00

        1. 8.8.1 Economic Environment

          $152.00

          1. Table | Macroeconomic Indicators, 2006 – 2021

          2. Figure 8-1 | Annual Growth in Real GDP, 2000 – 2016, Compared to 1980 – 2005 Average

        2. 8.8.2 Demographic Trends

          $154.00

          1. Table | Population & Households, 2006 – 2021

          2. Figure 8-2 | Annual Population Growth, 2001 – 2016

      9. 8.9 Consumer Spending Environment

        $132.00

        1. Table | Personal Consumption Expenditures, 2006 – 2021

      10. 8.10 Building Construction Outlook

        $102.00

        1. Table | Building Construction Expenditures, 2006 – 2021

      11. 8.11 Business Establishment Trends

        $153.00

        1. Table | Business Establishments, 2006 – 2021

      12. 8.12 Regional Demographic Trends

        $149.00

        1. Table | Population by Region, 2006 – 2021

        2. Figure 8-3 | Share of Population by Region, 2006 – 2021

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