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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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Report to Congress

Certified Community Behavioral Health Clinics Demonstration Program: Report to Congress, 2019

September 11, 2020
September 2020 Printer Friendly Version in PDF Format (32 PDF pages)

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.
ASPE Issue Brief

Medicare Beneficiary Use of Telehealth Visits: Early Data From the Start of the COVID-19 Pandemic

July 27, 2020
This ASPE issue brief examines changes in Medicare fee-for-service primary care visits and use of telehealth at the start of the COVID-19 public health emergency (PHE). This brief seeks to address the issue of how and whether the Medicare telehealth flexibilities introduced to address the COVID-19 pandemic may have helped maintain access to primary health care during the PHE.

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.
ASPE Issue Brief

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.

IV-E Prevention Toolkit: Identifying and Engaging Partners

March 11, 2020
This toolkit aims to help states develop a plan for Title IV-E prevention services, and to assist states in planning a comprehensive array of services to help prevent the need for foster care placement (“prevention services”) by braiding Title IV-E prevention services reimbursement with Medicaid and other funding mechanisms.
ASPE Issue Brief

Functional Trajectories at the End of Life for Individuals with Dementia Issue Brief

February 9, 2020
Dementia, including Alzheimer’s disease and related disorders, is a neurocognitive disease affecting an individual’s cognitive function and behavior. Dementia is a leading cause of death and is particularly prevalent at the end of life (EOL) in older adults.


February 9, 2020
ECONOMIC IMPACTS OF PROGRAMS TO SUPPORT CAREGIVERS: FINAL REPORT Stipica Mudrazija and Richard W. Johnson Urban Institute January 2020 Printer Friendly Version in PDF Format (68 PDF pages)