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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.

Reports

Displaying 1 - 10 of 1023. 10 per page. Page 1.

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ASPE Issue Brief

Understanding the Impact and Costs Associated with Medical Device Shortages During the COVID-19 Pandemic on Providers, Health Systems, Patients, and Manufacturers

We conducted a landscape analysis to understand the characteristics, impacts, and costs associated with medical device shortages during the COVID-19 pandemic in the U.S. Among health systems, nursing homes and rural hospitals were the most impacted by medical device shortages due to high demand and supply transportation issues.
ASPE Issue Brief, Report

Rebalancing of Medicaid-Funded Long-Term Services and Supports, 2016-2019

Shifting spending and delivery of long-term services and supports (LTSS) from institutions to the home and community is often referred to as rebalancing. This report and brief describe variation in LTSS rebalancing between 2016 and 2019 by enrollee age, health condition, and demographic factors.
ASPE Issue Brief

Long COVID among Essential Workers, Non-Essential Workers, and Not Working Persons in the United States, 2022-2023

The Office of the Assistant Secretary for Planning and Evaluation (ASPE) released a report examining trends in prevalence of Long COVID among different types of workers and among individuals who were not working. Workers in different occupations face different risks of COVID infection, and, potentially, Long COVID, depending on the nature of their work.
Report

Behavioral Health Prevalence, Utilization, and Spending Among Older Adult Medicare Beneficiaries: A Chartbook

Older adults with behavioral health disorders often experience worse health and functional outcomes, have higher rates of emergency department visits, use more medications, and have higher health care costs than those without a behavioral health disorder. There is need for a greater understanding of the extent to which older adults experience behavioral health disorders.
ASPE Issue Brief

Postpartum Health Care Use in Medicaid During the COVID-19 Public Health Emergency: Implications for Extending Postpartum Coverage

This Issue Brief provides a descriptive analysis of postpartum health care use among the Medicaid population before and during the PHE, when the continuous enrollment condition was in effect.
ASPE Issue Brief, Report

Long-Term Services and Supports Reform

While the likelihood of needing any long-term services and supports (LTSS) is roughly a coin flip, the cost if one needs assistance for a long period of time can be catastrophic. For example, about one-in-five Americans turning age 65 today will have long-term care costs exceeding $200,000.
ASPE Issue Brief

The Impact of Alternative Payment Models on Medicare Spending and Quality, 2012-2022

We evaluated both the Center for Medicare and Medicaid Services Innovation Center (CMS Innovation Center) models and the Medicare Shared Savings Program (MSSP) and found that they have generated gross savings for all beneficiaries in the Traditional Medicare program while demonstrating positive impacts on selected quality measures.
ASPE Issue Brief

Medicare Part B Enrollee Use and Spending on Biosimilars, 2018-2023

Biosimilars provide competition for biologics, which account for a significant and growing portion of Medicare Part B drug spending. This report evaluates the current state of biosimilar competition in Medicare Part B and explores opportunities to achieve further savings.
Report

Definitions and Occupational Characteristics of Direct Support Professionals

This study explores duties and activities that distinguish the DSP occupation from other direct care workforce occupations to inform the consideration of a DSP SOC code and other workforce data collection efforts. This study also identifies information beyond what is needed to create a DSP SOC code that states need on the DSP workforce to address policy and workforce planning activities.
ASPE Issue Brief

Hospice Agency Changes of Ownership: An Analysis of Publicly Available Ownership Issue Brief

To improve Medicare provider and supplier enrollment data transparency, in 2023, the Centers for Medicare & Medicaid Services publicly released detailed ownership data, including data on change of ownership transactions, for Medicare-enrolled hospices. This brief presents a descriptive analysis of hospice agency changes of ownership nationally between 2018 and 2022.