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Elder Care Services to 2016

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US revenues to grow 5.2% annually through 2016
Revenues for the elder care services industry (i.e., skilled nursing, home health care, social services, continuing care, and assisted living) are expected to grow 5.2 percent per year through 2016 to $319.5 billion. Advances will be driven largely by demographic changes in light of increasing life expectancy, which is contributing to the rising number of individuals in the older population segments. Growth is further boosted by the large, post-World War II “baby boom” generation entering their retirement years.

The market will be restrained by continuing efforts at the state and federal levels to curb Medicaid and Medicare expenditures, often by limiting reimbursements or by directing patients to less expensive forms of care. For instance, the 2010 Patient Protection and Affordable Care Act expands support for home and community based services, including home health care and social services. Elder care service providers compete functionally with informal caregivers, typically family members; however, a growing number of older adults either do not have family members who are able to care for them, or simply prefer using professional care.

Home, community based services to grow the fastest
In 2011, skilled nursing facilities accounted for the largest share of elder care service revenue with 43 percent. However, home and community based services (e.g., home health care, social services, assisted living) are projected to achieve the fastest growth. Advances will be driven by continued state and federal efforts to shift Medicaid payments away from skilled nursing to more cost effective community based services. Additionally, many older adults prefer to age in place, remaining in their homes as long as possible.

Nonprofits to outpace for-profit entities
For-profit entities accounted for twothirds of elder care service revenues in 2011, benefiting from the growing use of the chain and franchise business model. However, nonprofits (e.g., charitable organizations and government-related agencies) are expected to slightly outpace for-profits through 2016.

Medicaid to remain leading payment source
Medicaid will continue to be the leading payment source for the elder care services industry despite efforts at the state and federal levels to curb expenditures. Medicare payments will experience the fastest annual growth, though future legislative changes and fluctuating reimbursement rates have the potential to affect that outlook. Out-of-pocket expenditures continue to be important in the continuing care and assisted living industries, as many of the costs of these services are not covered by Medicare or Medicaid. Private insurance coverage will rise as the aged population grows and individuals who doubt the government’s ability to provide future care purchase long term care insurance. Other payment sources include charitable donations, private grants, and other government resources such as the US Veterans’ Administration.

Study coverage
Details on these and other findings are contained in Elder Care Services, the upcoming Freedonia industry study available for $4900. It presents historical data for 2001, 2006, and 2011, plus forecasts for 2016 and 2021 by service, provider and payment source. This study also considers market environment factors, evaluates company market share and profiles 40 US industry players, including Atria Senior Living, Brookdale Senior Living, Emeritus, Five Star Quality Care, Genesis Healthcare, Golden Living, HCP, and Manor Care.



General 4
Demographic Trends 4
Macroeconomic Outlook 9
Consumer Spending Trends 12
Building Construction Trends 15
Business Establishment Trends 18
Service Sector Outlook 21
Health Care Trends 24
National Health Expenditures 25
Medical Conditions 27
Chronic Conditions 28
Acute Conditions 30
Regulatory Environment 32
World Markets 35

General 38
Skilled Nursing Care Facilities 41
Overview 42
Employees 45
Regulations 47
Providers 49
Payment Sources 51
Home Health Care Services 53
Overview 54
Employees 57
Regulation 59
Personal Emergency Response Services 59
Providers 63
Payment Sources 65
Social Services 66
Overview 67
Adult Day Care 69
Non-Medical Home Care 72
Others 74
Providers 74
Payment Sources 75
Continuing Care Retirement Communities 77
Overview 78
Providers 81
Payment Sources 84
Assisted Living Facilities 86
Overview 87
Employees 89
Regulations 90
Providers 91
Payment Sources 93

General 95
For-Profit 97
Nonprofit 101

General 105
Medicaid 108
Overview 108
Medicaid Payments for Elder Care Services 110
Out-of-Pocket 113
Medicare 117
Overview 118
Medicare Payments for Elder Care Services 121
Private Insurance 125
Overview 126
Long Term Care Insurance 129
Private Insurance Payments for Elder Care Services 131
Other 134

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Elder Care Services to 2016


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