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Long-Term Services & Supports, Long-Term Care

ASPE conducts research, analysis, and evaluation of policies related to the long-term care and personal assistance needs of people of all ages with chronic disabilities. ASPE’s work also highlights the financing, delivery, organization, and quality of long-term services and supports, including those supported or financed by private insurers, Medicaid, Medicare, and the Administration for Community Living (ACL). This includes assessing the interaction between health care, post-acute care, chronic care, long-term care, and supportive services needs of persons with disabilities across the age spectrum; determining service use and program participation patterns; and coordinating the development of long-term care data and policies that affect the characteristics, circumstances, and needs of people with long-term care needs, including older adults and people with disabilities. 

Most Older Adults Are Likely to Need and Use Long-Term Services and Supports

More than one-half of older adults, regardless of their lifetime earnings, are projected to experience serious LTSS needs and use some paid LTSS after turning 65. 

Older adults with limited lifetime earnings are more likely to develop serious LTSS needs than those with more earnings. 

However, fifty-six percent of older adults in the top lifetime earnings quintile receive some paid LTSS, and the likelihood of nursing home care does not vary much by lifetime earnings. Learn more.


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Integrating Care through Dual Eligible Special Needs Plans (D-SNPs): Opportunities and Challenges

The 11 million individuals dually-eligible for Medicare and Medicaid are among the highest need populations in either program. However, a lack of coordination between the Medicare and Medicaid programs makes it difficult for individuals enrolled in both to navigate these fragmented systems of care and adds to the cost of both programs.

How Many Older Adults Can Afford To Purchase Home Care?

To estimate home much paid home could possibly be purchased out of income and wealth, we estimated the share of older adults with sufficient monthly income to cover median home care costs as well as other living expenses. Our results show that many older adults with severe LTSS needs could not afford 2 years of paid home care without financial assistance.

What Is the Lifetime Risk of Needing and Receiving Long-Term Services and Supports?

This brief provides new evidence on the lifetime risk that older adults will need LTSS and receive paid services and supports.

Patterns of Care and Home Health Utilization for Community-Admitted Medicare Patients

This study conducted exploratory analyses to develop a better understanding of community-admitted Medicare home health patients, including whether there have been any differential trends between community-admitted and post-acute care (PAC) patients over time and what their patterns of care tell us about the underlying reasons for the community-admitted increased numbers.

Primary and Behavioral Health Care Integration Program: Impacts on Health Care Utilization, Cost, and Quality

This report describes an extension of the RAND Corporation's evaluation of the Substance Abuse and Mental Health Services Administration's Primary and Behavioral Health Care Integration (PBHCI) grants program.
Report to Congress

Report to Congress: Current State of Technology-Enabled Collaborative Learning and Capacity Building Models

This report responds to the December 2016 “Expanding Capacity for Health Outcomes (ECHO) Act,” Public Law 114-270, which requires the Department to report to Congress on a range of issues related to technology-enabled collaborative learning and capacity building models and make recommendations on their use.  This report consists of a summary document that includes the Department’s recommendatio
ASPE Issue Brief

Housing and Delivery System Reform Collaborations: Issue Brief

Brenda C. Spillman, Joshua Leopold, Eva H. Allen and Pamela Blumenthal Urban Institute Printer Friendly Version in PDF Format (25 PDF pages)

Final Outcome Evaluation of the Balancing Incentive Program

Printer Friendly Version in PDF Format (41 PDF pages)

Perspectives of Physicians in Small Rural Practices on the Medicare Quality Payment Program

The objectives of this research effort were to collect feedback through interviews with physicians in small rural practices on the initial implementation of Medicare’s Quality Payment Program in 2017, a new value-based purchasing program for Medicare physicians.

Community-Dwelling Older Adults with Dementia and Their Caregivers: Key Indicators from the National Health and Aging Trends Study

Winnie Chi, PhD, Emily Graf, BA, Landon Hughes, BA, Jean Hastie, MPH, Galina Khatutsky, MS, Sari B. Shuman, MPH, MSW, E. Andrew Jessup, and Sarita Karon, PhD RTI International Helen Lamont, PhD