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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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Trends in the Use of Residential Settings among Older Adults Issue Brief

October 15, 2020

Projections of Poverty and Program Eligibility during the COVID-19 Pandemic

October 15, 2020
The COVID-19 pandemic and the slowdown in economic activity have impacted the well-being of many U.S. families. Unemployment peaked at 14.7 percent in April, and remained above 8 percent in August. The CARES Act and the Family First Coronavirus Response Act used several short-term policy strategies to address this challenge.
Research Brief

Advance Care Planning Among Medicare Fee-For-Service Beneficiaries and Practitioners: Research Brief

September 30, 2020
Advance Care Planning Among Medicare Fee-For-Service Beneficiaries and Practitioners: Research Brief Fang He, PhD; Angela Gasdaska, BS; Hannah Friedman, BA; Brendan Wedehase, BS; Alexis Kirk, PhD; Ila Broyles, PhD; Sarita L.


September 30, 2020
ADVANCE CARE PLANNING AMONG MEDICARE FEE-FOR-SERVICE BENEFICIARIES AND PRACTITIONERS: FINAL REPORT Fang He, PhD, Angela Gasdaska, BS, Hannah Friedman, BA, Brendan Wedehas, BS, Alexis Kirk, PhD, Ila Broyles, PhD, and SaritaL.
ASPE Issue Brief

The Impact of COVID-19 on Medicare Health Services and Payments

September 28, 2020
Beginning in mid-March 2020, the COVID-19 pandemic has had an unprecedented impact on health care utilization. The impact on patients, their families and the health care system was significant.

HHS Secretary's Report on: Addressing Surprise Medical Billing

July 28, 2020
This report responds to a requirement in Executive Order 13877, "Improving Price and Quality Transparency in American Healthcare to Put Patients First." It describes the phenomenon of a "surprise billing," particularly in the commercial insurance market, the underlying federal and state regulatory frameworks, and recent state actions to address the problem.

Research Summit on Dementia Care 2020: Workforce Development Stakeholder Recommendations

July 9, 2020
This is the PDF version of the Research Recommendations from the Workforce Development Stakeholder Group prepared for the 2020 National Research Summit on Care, Services, and Supports for Persons with Dementia and Their Caregivers (also called the Research Summit on Dementia Care).
ASPE Issue Brief

Potential Impacts of Minimum Wage Increases on Nursing Homes: Issue Brief

June 29, 2020
Nursing homes employ large proportions of their workforce at the minimum wage. This project sought to understand the potential impacts of federal minimum wage increases on nursing staff hours and labor costs of nursing homes.

Individuals Experiencing Homelessness are Likely to have Medical Conditions Associated with Severe Illness from COVID-19 Issue Brief

June 24, 2020
This brief uses a proprietary dataset of electronic health records to describe the prevalence rates of chronic health conditions associated with a higher risk of severe illness from COVID-19 among people with a history of homelessness. The paper found that for many of the health conditions examined, people with a history of homelessness have greater prevalence than the general population.

Reducing Recidivism and Improving Reentry through Economic Impact Payments during COVID-19

May 21, 2020
Economic Impact Payments under the CARES Act can increase economic independence and labor force attachment among individuals reentering from incarceration through helping cover basic expenses while individuals seek employment and get on their feet.