Need for Sustainable Financing of Long Term Services for United States Seniors


According to the United States Department of Health and Human Services’ Administration on Aging, in 2014, there were 46.2 million people 65 years and older in the U.S. This number is expected to grow to 98 million by 2060, with a significant proportion requiring long term services and supports (LTSS) to help with activities of daily living (such as bathing, dressing, eating) and instrumental activities of daily living (such as medication management, financial management, and housecleaning) due to physical, developmental or cognitive impairments.


LTSS are provided by skilled nursing facilities, assisted living facilities, senior living communities, community senior agencies, home aide agencies and family/friend caregivers. Unfortunately, Medicare does not pay for these services. Currently, the methods of financing these services are Medicaid, private long term insurance policies, private pay services, and unpaid caregivers. The challenge is that none of these methods alone is sustainable, affordable, or  available to a socioeconomically diverse aging population.

그림3.pngThe U.S. Congress has made various efforts to promote community and social program support for the aging population, however, it has been unable to pass comprehensive legislation that would allow for public funding of LTSS  due to lack of bipartisan support and the diversity of needs that must be met. Several non-governmental senior and public policy advocacy groups, such as the National Council on Aging, the Bipartisan Policy Center (BPC), The Convergence Center for Policy Resolution and Leading Age have recognized that a multipronged approach to sustainably financing LTSS which includes expanding Medicaid options for community and home based services, making private long term insurance more affordable, and creating a plan to finance LTSS for high utilizers is needed.

Continued collaboration between governmental health agencies (federal and states), advocacy groups, LTSS providers, private insurance companies and seniors is required to create actionable proposals to present to Congress in the next 2-5 years.

Written by Aruna Josyula, Euijae Kim


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2 Responses to “Need for Sustainable Financing of Long Term Services for United States Seniors”

  1. oyetunjiblog Says:

    This is such an important issue that many people are unaware of until they have a loved one who is in need of LTSS. As you mentioned, the options currently available for financing are limited and many people end up spending their retirement funds and life savings on LTSS. I have an inkling that this issue will come to a head in the near future given the aging baby boomer population and the unsustainable healthcare costs.

    Unfortunately, I also know that it is very likely that nothing will be done until it is too late.

    • ajosyulamd Says:

      Thank you for your comment. I agree with you that it might take too long to see any significant change in funding on a broad scale. Currently, I’m involved in an innovative project that is grant funded to help keep people home and find them the appropriate support services. With the work we have been doing, it might be easier to get private funding to continue to support the needs of my community, but translating that to a national scale would be a very slow process.

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