An estimated 12 million Americans are currently in need of long-term services and supports (LTSS)—defined as institutional or home-based assistance with activities of daily living such as bathing, dressing, or medication management—including both seniors and persons under age 65 living with physical or cognitive limitations. In the next two decades, the U.S. health care system will face a tidal wave of aging baby boomers. This, among many other factors, will create an unsustainable demand for LTSS in the coming years. Fewer family caregivers, increasingly limited personal financial resources, and growing strains on federal, state, and family budgets will further complicate efforts to organize and finance services.
Although there is tremendous variation in what is, or will be, needed, fully 70 percent of people who reach the age of 65 will require some form of LTSS at some point in their lives. The number of Americans needing LTSS at any one time is expected to more than double from 12 million today to 27 million by 2050. Indeed, the demand for LTSS will substantially outpace the rate of growth in the U.S. economy over the next decade and drive significant growth in Medicaid spending.