Projections of Risk of Needing Long-Term Services and Supports at Ages 65 and Older


Projections of Risk of Needing Long-Term Services and Supports at Ages 65 and Older

Melissa M. Favreault and Richard W. Johnson

Urban Institute

January 2021

Link to HTML Version (78 PDF pages)

ABSTRACT: This report provides projections of the risk of needing long-term services and supports (LTSS) from age 65 to death from the Urban Institute's Dynamic Simulation of Income Model. We present projections of the durations of LTSS needs and use, the types of settings in which they are provided (home care, residential care, and nursing homes), and the costs of formal services. We then describe who bears these costs, considering government payers like Medicaid, Medicare, and other public sources (such as the Veterans' Administration) as well as private payers, including families and long-term care insurance companies.

This report was prepared under contract #HHSP233201600024I between HHS's ASPE/BHDAP and the Urban Institute. For additional information about this subject, you can visit the BHDAP home page at or contact the ASPE Project Officers, at HHS/ASPE/BHDAP, Room 424E, H.H. Humphrey Building, 200 Independence Avenue, S.W., Washington, D.C., 20201;,,

DISCLAIMER: The opinions and views expressed in this report are those of the authors. They do not reflect the views of the Department of Health and Human Services, the contractor or any other funding organization. This report was completed and submitted in May 2020.


"LTSSRisk.pdf" (pdf, 1.77Mb)

Note: Documents in PDF format require the Adobe Acrobat Reader®. If you experience problems with PDF documents, please download the latest version of the Reader®