Medicaid spent approximately 154.4 billion U.S. dollars on long-term care services in 2022, which was an increase on the previous year. California, New York, and Ohio were the states with the highest long-term care expenditures.

States support home- and community-based care Combined spending on nursing care facilities, home health care, and other health care made up roughly one-third of Medicaid’s total costs in 2019. Other health care costs include home- and community-based waiver programs that allow people to receive long-term care at home or in their community. Nearly all states offer the waivers, which can substantially reduce expenditures for Medicaid enrollees who would otherwise have to enter a long-term institutional service, such as a nursing home. In recent decades, the distribution of Medicaid’s long-term care services expenditures has shifted toward home- and community-based care.

The costs of in-home care are rising Long-term care expenditures vary depending on the setting, location, and level of care required. In 2020, the annual median cost of long-term care in the United States ranged from 19,240 U.S. dollars for adult day health care services to 105,850 U.S. dollars for a private room in a nursing home. In general, the costs of nursing home facilities were considerably higher than those for home care and community living options. However, in-home care reported the highest year-on-year cost increases, and growing demand for the services has led to a rise in spending on home health care over recent years.

In 2024, the annual median cost for long-term care in the United States ranged from 26,000 to 127,750 U.S. dollars, depending on the type of service. This significant financial burden highlights the importance of planning for future healthcare needs, as many older adults may face substantial out-of-pocket costs for extended care services. Nursing homes and assisted living facilities Nursing homes represent the most expensive long-term care option, with private rooms costing an estimated 10,646 U.S. dollars per month in 2024. Semi-private rooms are slightly more affordable at 9,277 U.S. dollars monthly. Assisted living facilities offer a less costly alternative, with annual expenses for a private room averaging 70,800 U.S. dollars. However, these costs can vary dramatically by location, with states like Hawaii, Alaska, and Washington D.C. commanding the highest prices for assisted living accommodations. Home care services and future projections For those preferring to receive care at home, the hourly rates for long-term home care services in 2024 were 33 U.S. dollars for homemaker services and 34 U.S. dollars for home health aide services. These costs are expected to rise significantly in the coming decades, with projections suggesting home health aide services could approach 100 U.S. dollars per hour by 2060. The increasing expense of long-term care is evident across all service types, with assisted living facilities experiencing a 10 percent cost increase from 2023 to 2024, while nursing home rates for semi-private and private rooms rose by 7 and 9 percent, respectively.

The Managed Long-Term Care (MLTC) performance data is an annual evaluation (semi-annual prior to 2022) of New York state-certified MLTC plans. Rates are calculated for each performance measure by plan and describe their population, quality of care, and enrollees’ satisfaction. These data also present the statewide demographic profile of MLTC enrollees and statewide rates of emergency room, hospital, and nursing home utilization. Refer to the Measures document to learn more about specific MLTC measures. In the future, as more evaluations are performed, measures can be trended over time. Refer to the Overview document for information on the data sources, time frames, and limitations of this dataset.

There has been a noticeable shift in the distribution of expenditures among Medicaid long-term care services over the past three decades. In 1990, home- and community-based care accounted for 13 percent of the program’s long-term care costs, but this has risen to a majority share of approximately 65 percent by 2022. Institutional care rates continue to fall Medicaid spent approximately 32 billion U.S. dollars on long-term care services in 1990, and close to 90 percent of that went towards institutional care, such as nursing homes and other residential facilities. The decrease over recent years in the proportion of spending devoted to institutional care can be partly attributed to a push towards home- and community-based care. This expansion of services is growing in popularity because individuals can receive treatment in familiar surroundings and benefit from increased levels of comfort. State variations in long-term care costs Medicaid expenditures for long-term care services vary significantly from state to state, which is primarily due to each state being able to administer its Medicaid program differently. On average, Medicaid spent 19 percent on long-term care in 2022.

On an annual basis (based on individual Long-Term Care (LTC) facility fiscal year end), California licensed LTC facilities report detailed financial data on facility information, ownership information, patient days & discharges, Balance Sheet, Equity Statement, Cash Flows, Income Statement, Revenue by type and payer, Expense Detail, and Labor Detail. Based on the selected data set, the pivot tables display summarized data on a Profile page and also provides charts on various data items such as Patient Days, Revenue & Expense, and Revenue.

Diverse service offerings and strategic consolidation efforts drive revenue growth. Various products cater to different age demographics, with younger buyers under 55 often securing policies early to lock in lower premiums and those between 55 and 65 contributing significantly because of optimal pricing. While adults over 65 have shown growth, high premiums and elevated risks limit their contribution. Through mergers, companies can pool resources, streamline administration and offer competitive premiums, reinforcing market concentration despite the competition from government substitutes like Medicaid. Industry revenue has been growing at a CAGR of 2.4% to a total of $25.6 billion in 2025 when revenue will jump by an estimated 4.0% in 2025 alone. Healthcare costs and consumer awareness are critical for sustaining growth, especially amid increased competition from substitute programs. Rising medical and facility care expenses lead insurers to adjust premiums to maintain revenue, potentially decreasing market demand. As wages for healthcare professionals climb, insurers are challenged to balance affordability with coverage options, mindful of claim denial rates and costs of appeals. Consumer education on the variety of policies available and the pricing implications is essential, as misunderstandings can deter purchases. By enhancing transparency and educating consumers about preventative care's significance, insurers can foster a committed customer base, thereby boosting long-term demand. Technological advancements and diverse policy offerings will drive demand and reduce costs, supporting profit. Larger insurers leverage their size to provide varied products, from hybrid plans to specialized coverage, appealing to consumer preferences. Medical and technological progress, such as AI-driven data analytics, promotes lower health payouts, better risk assessment and pricing precision. Also, advancements in preventive care and wellness programs can mitigate the need for expensive long-term care, reducing claim frequency and cost-balancing the increased duration of claims. These innovations, in concert, enable insurers to maintain competitive pricing, extend market reach and enhance profitability by attracting a broader customer base while managing changes in healthcare costs. Looking forward, industry revenue will climb at a CAGR of 3.1% through 2030 to total $29.8 billion, with profit to climb marginally during the outlook period.

The hourly rate of long-term home care services has increased in the United States and is expected to increase further in the future. In 2024, the cost for long-term care in the U.S. was 33 U.S. dollars per hour for homemaker services and 34 U.S. dollars per hour for home health aide services. By 2030, prices for such services are expected to surpass 39 dollars an hour. By 2060, a price of nearly 100 dollars per hour was forecasted for home health aide services.

On an annual basis (calendar year), individual LTC facilities report facility-level data on services capacity, utilization, patients, and capital/equipment expenditures.

In 2023, the average expenditure on long-term care insurance in the United States amounted to 56 U.S. dollars per consumer unit. The cost of long-term health care services in the U.S. depends on the level of privacy and service included. A private room in a nursing home being the most expensive option.

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Long-Term Care Market Size 2024-2028

The long-term care market is expanding steadily, driven by an aging global population, rising chronic disease prevalence, and increasing demand for personalized care solutions. Valued at USD 1.12 trillion in 2023, the market is projected to grow by USD 394.8 billion, reaching USD 1.51 trillion by 2028, with a compound annual growth rate (CAGR) of 3.21%. From nursing homes in the United States to home healthcare services in Japan, Long term care is addressing diverse needs across regions. This includes the development of telehealth services, remote patient monitoring technologies, and other digital health solutions. These innovations are expanding the market's scope and ensuring its continued evolution. This comprehensive analysis explores the drivers, segments, trends, challenges, and recent developments shaping the long term care market, spotlighting key players like Brookdale Senior Living, Genesis HealthCare, and Amedisys, and offering actionable insights for stakeholders in this vital sector.

What will be the Size of the Long-Term Care Market during the forecast period?

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Key Drivers of the Long-Term Care Market

A confluence of factors is fueling the long term care market, establishing it as a critical component of global healthcare systems:

Aging Population: With over 1 billion people aged 65+ globally by 2024, countries like Japan and Germany face rising demand for nursing care and dementia services.
Chronic Disease Prevalence: Increasing cases of diabetes and heart disease in the US and India drive demand for home healthcare and hospice care.
Technological Advancements: Telehealth and wearable devices, adopted by Amedisys in the US, enhance remote monitoring and care delivery.
Government Support: Policies like Medicare in the US and China's elderly care initiatives fund long term care services, boosting accessibility.
Shifting Preferences: Growing preference for home-based care in Canada and Brazil supports the expansion of home healthcare services.

Case Study: Home Healthcare in Canada

A Canadian provider, Bayshore HealthCare, implemented telehealth-enabled home care for chronic illness patients, reducing hospital readmissions by 30%. The program's success in Ontario highlights the growing role of technology in delivering personalized long term care solutions.

How is this Long-Term Care Industry segmented?

The long-term care industry research report provides comprehensive data (region-wise segment analysis), with forecasts and estimates in 'USD billion' for the period 2024-2028, as well as historical data from 2018-2022 for the following segments.

Type

  Government
  Public and private players
  Out of the pocket
  Private insurance


Application

  Nursing care and assisted living facilities
  Home healthcare
  Hospice


End-User

  Elderly (65+)
  Younger Adults with Disabilities
  Chronic Illness Patients
  Dementia/Alzheimer's Patients


Geography

  North America

    US
    Canada


  Europe

    France
    Germany


  Middle East and Africa

    UAE


  APAC

    China
    India
    Japan


  South America

    Brazil


  Rest of World (ROW)

Market Segmentation: A Detailed Breakdown

The Long term care market is diverse, segmented by type, application, end-user, and geography, each contributing to its steady growth. Here's an in-depth analysis for 2024-2028:

By Type

Government: Government-funded long term care programs, such as Medicare in the US and public health schemes in Germany, provide subsidized care for the elderly and disabled. These programs support nursing homes, home healthcare, and hospice services, ensuring accessibility for low-income populations. In Canada, government initiatives fund assisted living facilities, promoting aging-in-place models. Investments in dementia care are rising, particularly in Japan. The reliance on public funding drives innovation in cost-effective care delivery models.
Public and Private Players: Public-private partnerships and private providers like Brookdale Senior Living in the US deliver a mix of nursing care and assisted living services. In France, private operators collaborate with public systems to expand home healthcare. These players invest in technology, such as remote monitoring, to enhance care quality. Their flexibility allows rapid adaptation to regional needs, particularly in APAC. This segment thrives on balancing affordability with premium care offerings.
Out of the Pocket: Self-funded long term care, common in India and Brazil, involves individuals paying directly for nursing care or home healthcare. This model is prevalent among middle-class families seeking personalized services. In the UAE, out-of-pocket spending supports luxury assisted living facilities. The lack of insurance coverage in some regions drives this segment's growth. It caters to patien

The Foreign Service Act of 1980 mandated a comprehensive revision to the operation of the Department of State and the personnel assigned to the US Foreign Service. As the statutory authority, the Foreign Affairs Manual (FAM), details the Department of Sta

According to a survey conducted in March 2021, most people in the U.S. believe that either health insurance companies or Medicare should cover the costs of long-term care. Indeed, one out of two respondents considered that one of these institutions should bear the cost of ongoing living assistance. On the other hand, 35 percent of respondents thought that they should cover such costs.

In the United States, nearly half of surveyed adults said they encountered unexpected costs for things they thought would be included but were added on as extra charges by a long-term care facility. This was among those who, in the past two years, were a resident, or a loved one was a resident of a nursing home, assisted living facility, or other LTC facility.

The Long-Term Care (LTC) Supplement contains data on the functional status of persons responding to Rounds 1 and 4 of the Household Survey of the 1987 National Medical Expenditure Survey (NMES). The series of questions on functional status includes items on Activities of Daily Living (ADL) and instrumental ADL (IADL), continence, and use of special equipment. For those persons having at least one ADL or IADL difficulty, questions were asked about use of community services such as adult day care, senior centers, home-delivered and congregate meals, special transportation, and telephone assurance. Information was also sought on prior nursing home stays, and financial help from someone outside of the household. The Demographics and Sampling Weights file contains person-level data for individuals who responded for their entire period of NMES eligibility (Rounds 1, 2, 3, and 4). Each record contains person identifiers, selected characteristics including age, sex, race/ethnicity, and census region, dates of interview, a response-per-round indicator for the LTC Supplements, imputation flags for ADL/IADL, and sampling weight variables. The LTC Supplement population represented in File 2 is a subset of persons in File 1. File 2 is composed of separate records for LTC data collected during Round 1 (N=33,971) and during Round 4 (N=33,986).

Life Insurers: Expenditures: Contract Payments: Health Insurance: Long term care data was reported at 9.584 USD bn in 2023. This records an increase from the previous number of 6.167 USD bn for 2022. Life Insurers: Expenditures: Contract Payments: Health Insurance: Long term care data is updated yearly, averaging 8.040 USD bn from Dec 2019 (Median) to 2023, with 5 observations. The data reached an all-time high of 9.584 USD bn in 2023 and a record low of 6.167 USD bn in 2022. Life Insurers: Expenditures: Contract Payments: Health Insurance: Long term care data remains active status in CEIC and is reported by National Association of Insurance Commissioners. The data is categorized under Global Database’s United States – Table US.RG006: Life Insurance: Contract Payments.

The United States Department of Health and Human Services initiated this survey to demonstrate and evaluate the cost savings and effectiveness of applying a case management approach to community-based long term care services for the frail elderly. The goal of case management is to coordinate and direct community, medical, and informal long term care services to the frail elderly as an alternative to institutionalization. The four main areas of evaluation are: 1) the use of hospitals, nursing homes, and other formal medical services, 2) public and private expenditures on formal community services including case-management, housing, and income transfers, 3) informal care by family and friends, and 4) individual outcomes, including quality of life, physical functioning, unmet service needs, and mortality of the elderly sample members.

This report estimates the economic value of family caregiving at $450 billion in 2009 based on 42.1 million caregivers age 18 or older providing an average of 18.4 hours of care per week to care recipients age 18 or older, at an average value of $11.16 per hour. This data is not collected by a government agency. The findings and conclusions in this report are those of the author and do not necessarily represent the views of the Department of Health & Human Services.

This statistic displays the state of long-term care financing in distributed by various payers in the United States as of 2013. Family out-of-pocket costs accounted for 63 billion U.S. dollars in one year. In the United States, almost 725 billion U.S. dollars is spent every year on long-term health care. It is estimated that around 450 billion U.S. dollars of that is unpaid family caregiving.

The nursing facility industry faces dynamic challenges and opportunities as it adapts to emerging trends and changing demographics. Recent performance indicates rising costs and demands because of an aging population and regulatory pressures. Labor shortages complicate operations, compelling facilities to offer higher wages to attract skilled staff. Financial pressures escalate with increased spending on modern technology and regulatory compliance. Despite the strains, some facilities innovate by incorporating telehealth and specialized services to attract privately insured residents and those on government programs. This strategic approach helps balance operational challenges with potential growth opportunities as demand continues. Revenue grew at a CAGR of 1.4% through 2025, projected to reach $167.5 billion in 2025 with a 3.5% revenue increase. Over the last five years, profitability in nursing facilities has been challenging, shaped by intricate factors such as cost structure and reimbursement rates. Wage expenses represent a substantial financial burden driven by labor shortages and regulatory mandates. Facilities must manage escalating costs in food, medications and supplies while dealing with rising rent expenses and the need for advanced technology. Despite these financial strains, high occupancy rates contribute to higher profitability. Facilities prioritize private insurance patients for better reimbursement rates yet must rely on government-funded residents in certain regions. The blend of innovative care models, careful resource management and strategic financial partnerships underpins the industry's ability to remain viable and competitive. The coming five years bring anticipated growth fueled by demographic shifts and evolving care models. Increased occupancy is expected as the older adult population expands, providing new revenue prospects. Facilities will likely see a broader demand for varied care models, necessitating enhancements in infrastructure and personalized services. With potential funding increases from Medicare and Medicaid, there are opportunities for investment in staff training and specialized care. Consolidation trends continue to reshape the landscape, enabling facilities to expand services and leverage economies of scale. Focusing on short-stay, post-acute care and adapting to managed care frameworks could enhance financial resilience. Integrating technology and strategic partnerships may redefine services, ensuring long-term sustainability in a competitive environment. Industry revenue is projected to climb at a CAGR of 2.7%, reaching $191.6 billion by 2030.

The global nursing care facilities market, valued at $269.36 million in 2025, is projected to experience robust growth, driven by an aging global population and increasing prevalence of chronic diseases requiring long-term care. A compound annual growth rate (CAGR) of 4.0% is anticipated from 2025 to 2033, indicating a significant market expansion. Key drivers include rising healthcare expenditure, growing demand for specialized geriatric care, and increasing government initiatives promoting community-based long-term care services. While the market faces challenges such as staff shortages, rising operational costs, and stringent regulatory compliance, the persistent demand for quality nursing care, particularly among the elderly, is expected to mitigate these restraints. The market is segmented by type (hospice, nursing care, assisted living facilities) and application (male and female patients), reflecting the diverse needs within the senior care sector. North America, particularly the United States, holds a significant market share owing to its advanced healthcare infrastructure and substantial aging population. However, emerging markets in Asia-Pacific and other regions are demonstrating substantial growth potential, fueled by increasing disposable incomes and improved healthcare access. The competitive landscape includes both large, established players like Brookdale Senior Living and Sunrise Senior Living, alongside smaller regional providers. Strategic mergers and acquisitions, coupled with investments in advanced technologies and personalized care models, are key competitive strategies within the industry. The forecast period (2025-2033) will witness a continued shift toward patient-centered care, with a greater emphasis on holistic well-being and integrated healthcare services within nursing care facilities. Technological advancements such as telehealth and remote patient monitoring are expected to improve efficiency and enhance the quality of care delivery. Furthermore, the market is likely to see increased adoption of value-based care models, focusing on positive patient outcomes and cost-effectiveness. This trend will necessitate ongoing innovation and adaptation by market players to meet evolving patient needs and regulatory demands. The ongoing growth trajectory indicates strong investment opportunities for companies that can effectively address the rising demand for quality nursing care within a rapidly evolving healthcare landscape.