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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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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

Tracking the Impact of Ownership Changes in Hospice Care Provided to Medicare Beneficiaries: Final Report

This study examines hospice ownership in detail by going beyond the general distinction of for-profit or not-for-profit and considers the extent to which regional or national chains have entered the hospice provider market and how the populations they care for and the services they provide might be distinct from other types of hospice agencies.

Trends in Nursing Home-Hospice Contracting and Common Ownership between Hospice Agencies and Nursing Homes: Final Report

Between 2005 and 2015, the number of hospice agencies with common ownership to nursing homes nearly quintupled in number and now represents almost 1-in-5 hospice agencies participating in the Medicare program.

Health Plan Choice and Premiums in the 2019 Federal Health Insurance Exchange

This brief presents information on qualified health plans (QHPs) available in the Exchange for states that use the platform, including estimates for issuer participation, health plan options, premiums, and subsidies in the upcoming open enrollment period (OEP), and trends since the first OEP. National estimates and summary tables are presented in each section of the text.

An Overview of Long-Term Services and Supports and Medicaid: Final Report

This report examines the role of long-term services and supports (LTSS) in Medicaid. It also examines how sociodemographic changes are likely to affect the demand for LTSS in the future, and as a result, Medicaid use and expenditures.
ASPE Issue Brief

Substance Use Disorder Workforce Issue Brief

Many barriers to accessing evidence-based treatment for substance use disorder (SUD), particularly medication assisted treatment, are related to the workforce. Barriers include workforce shortages for certain providers, insufficient training, education and experience, lack of institutional and clinician peer support, provider stigma and inadequate or burdensome reimbursement.

Research Summit on Dementia Care: Main Summit Recommendations

This is the PDF version of the 12 Recommendation Themes from National Research Summit on Care, Services, and Supports for Persons with Dementia and Their Caregivers: Report to the National Advisory Council on Alzheimer's Research, Care, and Service.