The Long Term Care Market: Nursing Homes, Home Care, Hospice Care, and Assisted Living

The Long Term Care Market: Nursing Homes, Home Care, Hospice Care, and Assisted Living

This Kalorama Information report, The Long Term Care Market: Nursing Homes, Home Care, Hospice Care, and Assisted Living provides detailed market research on the U.S. long-term care market. This market complex and diverse industry evolves nearly every year, and influences other markets such as the sales of pharmaceuticals, devices and healthcare services. For seven editions, Kalorama has provided a look at who is leading, what the opportunity is and will be in four key areas of long term care.

The reason for the importance of the market will not surprise. As the demographics of the U.S. population change, so have the attitudes toward long-term care. The long-term care industry has met the challenges of the changing industry by diversifying offerings and increasing specialized care. The U.S. long care industry has experienced steady growth from 2016 through 2018 and this is expected to continue through the forecast period. Aging of the population will increase demand for all forms of long-term care, although ongoing cost containment will continue to pressure the industry. Baby boomers account for approximately 67 million individuals in the United States in 2018 and this enormous group will be making decisions about whether senior living is the right option for their aging loved ones and eventually for themselves.

The evolution and specialization of residential, community-based, and home health care services will continue. The aging of the population, rising rates of chronic disease, longer life expectancies, and advances in public health and medical technology will result in unprecedented numbers of people requiring long-term care services in the near future – even as a shortage of health care personnel is occurring. The health care industry must begin to work now to reduce the fragmentation that exists both in the continuum of long-term care services and in the system of payment for those services.

Industry participants must stay current on and attentive to data trends, be prepared to quickly expand current programs, and collaborate with other care providers within their communities, and thereby be ready to serve an even greater number of people by providing seamless care that is accessible, effective, efficient, and affordable.

Scope and Methodology

  • This report covers the most important segments of the long-term care industry, each of which provide medical care and/or assistance with the activities of daily living (ADLs) on an ongoing basis:
  • Nursing care
  • Home care
  • Hospice care
  • Assisted living
Excluded are markets that address temporary care needs such as physical or mental rehabilitation as well as residential living programs and facilities that do not generally provide care such as retirement communities and/or continuing care retirement communities (CCRCs). Also excluded are equipment and supplies used in home care such as wheelchairs, beds, diabetic supplies, etc., as well as medications.

The Long Term Care Opportunity

Sales estimates for each market segment represent U.S. revenues and are expressed in current U.S. dollars. Estimates are provided for the historic 2016 to 2018 period and forecasts are provided through 2023. Historical information for this report was gathered from a wide variety of published sources including company reports and filings, government documents, legal filings, trade journals, newspapers and business press, analysts’ reports and other sources. Interviews with company representatives were conducted to capture the perspectives from industry participants’ point of view and assess trends and form the basis of the forecasting and competitive analysis.

Kalorama Information’s seventh edition of this detailed report on the long term care industry provides a size and forecast estimate for each of the critical segments noted above, including the following market information:
Overall U.S. Long Term Care Market 2015 – 2023 (Nursing Home Care, Home Care, Hospice Care, Assisted Living, Total)
U.S. Nursing Home Market, by Revenues, 2011 – 2020
Leading Competitors in the U.S. Nursing Home Market, by Revenues and Market Shares, 2018
U.S. Home Health Care Market, by Revenues, 2015-2023
Leading Competitors in the U.S. Home Health Care Market, by Revenues and Market Shares, 2018
U.S. Market for Hospice Care, by Revenues, 2015-2023
Leading Competitors in the U.S. Hospice Market, by Revenues and Market Shares, 2018
U.S. Market for Assisted Living, by Revenues, 2015-2023
Leading Competitors in the U.S. Assisted Living Market, by Revenues and Market Shares, 2018
Long Term Care Industry Revenues by Year, 2011, 2015, 2020
Long Term Care Industry Revenues by Major Player, 2018 (Nursing Home Care, Home Care, Hospice Care, Assisted Living, Total)

The U.S. health care industry continues to evolve in response to ongoing cost containment imperatives, aging of the population and relatively low rates of wellness within large segments of the general public (obese persons, diabetics, persons with addictions, etc.). This is leading to increased utilization of all forms of long-term care. For each of the segments of long term care, this report provides:

Historical information for this report was gathered from a wide variety of published sources including company reports and filings, government documents, legal filings, trade journals, newspapers and business press, analysts’ reports and other sources. Interviews with company representatives were conducted to capture the perspectives from industry participants’ point of view and assess trends, and form the basis of the forecasting and competitive analysis.

Competitive Analysis: Who is In the Market and Who is Winning?

This Kalorama Information report features a superior competitive analysis section. There are numerous companies in the long term care industry, but roughly 20 concerns stand out and are part of a profile in this report:

ALMOST FAMILY, INC/LHC GROUP
AMEDISYS, INC.
APRIA HEALTHCARE GROUP, INC
ATRIA SENIOR LIVING
BROOKDALE SENIOR LIVING, INC.
CAPITAL SENIOR LIVING
EXTENDICARE, INC
FIVE STAR SENIOR LIVING, INC
GENESIS HEALTHCARE
GOLDEN LIVING CENTERS
HCR MANOR CARE, INC
HOLIDAY RETIREMENT
HOME INSTEAD, INC.
KINDRED HEALTHCARE, INC.
KINDRED AT HOME
LIFE CARE CENTERS OF AMERICA
LIFE CARE SERVICES LLC
LINCARE HOLDINGS INC.
SUNRISE SENIOR LIVING, INC
THE ENSIGN GROUP
VISITING ANGELS LIVING ASSISTANCE SERVICES, INC
VITAS HEALTHCARE


  • Executive Summary
    • U.S. Long Term Care Industry
    • Scope and Methodology
    • Overall Market Size
      • Table Total U.S. Long-Term Care Market 2016-2023 (in billions$)
    • Long-term Care Issues and Trends
    • Competitive Landscape
  • Long Term Care Industry
    • The U.S. Health Care Industry
    • Long Term Care
      • Nursing Homes
      • Home Care
      • Hospices
      • Assisted Living
    • Demographics
      • U.S. Population
        • Table Projected U.S. Resident Population by Age, Selected Years (2015-2050) in thousands
      • Aging of the Population
        • Table U.S. Life Expectancy at Birth, by Sex and Race, 2016 (years)
        • Table U.S. Life Expectancy Projections at Birth and at Age 65, 2015-2016 (years)
        • Table U.S. Elderly Resident Population by Gender and Age, 2017 (in thousands)
      • Racial Trends
        • Table U.S. Resident Population by Age, Hispanic Origin, and Race, Selected Years 2012-2050 (in thousands)
        • Table U.S. Resident Elderly Population by Age, Hispanic Origin, and Race, Selected Years Percent (%) 2012-2050
      • Obesity
      • Marital and Living Arrangements
        • Table Marital Status of U.S. Residents Aged 65 and Older, 2016
      • Geographic Concentrations
        • Table U.S. Resident Population, by State and Age Comparison 2013 - 2017
      • Activities of Daily Living
        • Table Estimated Number of Nursing Home Residents by State, 2017
        • Table Disability Prevalence by Age, 2013
      • Chronic Illness
        • Table Frequencies of Selected Diseases Among Older Adults, 2016
        • Table Frequencies of Selected Diseases Among Older U.S. Adults, 2016
      • Addiction
      • Mental Illness
      • Income
        • Table U.S. Median Income by Householder Age, 2017
    • Health Care Reform
    • Quality of Care
      • Certification and Accreditation
    • U.S. Health Expenditures
      • Table Funding Sources for National Health Expenditures, 2016-2023 (000)
      • Table Funding Sources for Home Health Care Spending, 2016-2023 (000)
      • Table Funding Sources for Nursing Home Spending, 2016-2023 (000)
    • Consumer Preferences and Lifestyle Issues
      • The Elderly
      • Caregiver Issues
    • Fees and Payment
      • Medicare
      • Medicaid
      • Long Term Care Insurance
      • Numbers of Insured
      • Cost of Coverage and Affordability
      • Hybrid Plans
      • Effect of the Economy
        • Table Selected State Budget Shortfall in FY 2017 and FY 2018 (in millions)
    • The Managed Care Environment
    • Preparing for the Future
      • Staffing and Human Resources
      • Information and Education Initiatives
      • Medicaid Reform
        • Table State Specific Income Limit and Asset Limit, 2018
      • Building of New Facilities
      • Information Technology
    • Government Regulation Update
  • Nursing Homes
    • Description of Facilities
      • Services
      • Number of Facilities
    • Resident Population
      • Demographic Data
      • Functional Data
      • Length of Stay
      • Insurance Coverage
        • Table Primary Payment Sources for Nursing Home Residents, by State, 2016
    • Issues and Trends
      • Reimbursement Cuts
      • Health Care Reform
      • Reform of Requirements for Long-term Care Facilities
      • Patient Dumping
      • Quality of Care
        • Table U.S. Nursing Home Deficiencies by State, 2016
      • Staffing Issues
      • Federal Quality Improvement Initiatives
      • State Quality Improvement Initiatives
      • Legal Actions
      • Safety
    • Market Size and Forecast
      • Cost of Care
      • Size of the Market
        • Table U.S. Nursing Home Market 2016-2023 (in millions $ at manufacturer level)
    • Competitor Analysis
      • Table Leading Competitors in the U.S. Nursing Home Market, by Revenues and Market Share, 2018
    • Market Analysis
  • Home Care
    • Description of Facilities
      • Services
      • Number of Facilities
    • Resident Population
      • Demographic Data
      • Functional Data
        • Table Medicare Home Care Patients and Visits by State, 2011
      • Insurance Coverage
    • Issues and Trends
      • Conditions of Participation
      • Medicare Reimbursement
      • Medicaid Reimbursement
      • Medicare and Medicaid Co-payments
      • Home and Community Based Services
      • State Service Reductions
      • Improper Payments
      • Quality of Care
      • Disease Management
      • Staffing Issues
      • Caregiver Burnout
      • Technology and Telemedicine
      • Home Health Value-Based Purchasing
      • Home Health Payment Reform
      • Payment Rates
    • Market Size and Forecast
      • Cost of Care
      • Size of the Market
        • Table U.S. Home Care Market 2016-2023 (in millions $ at manufacturer level)
    • Competitor Analysis
      • Table Leading Competitors in the U.S. Home Health Care Market, by Revenues and % Market Share, 2018
    • Market Analysis
  • Hospices
    • Description of Facilities
      • Services
        • Table Services Offered to Hospice Patients' Family and Friends
      • Number of Facilities
        • Table Number of Medicare certified Hospices and Program Payments, by State 2010
    • Resident Population
      • Demographic Data
        • Table Proportion of Hospice Patients by Length of Service, 2016
      • Functional Data
        • Table Mean Length of Hospice Stay by Diagnosis, 2016
        • Table Drug Prescribed to U.S. Hospice Patients in the Last Week of Life
      • Insurance Coverage and Hospice Profitability
        • Table Average Medicare Reimbursement for Hospice Care, 2017
    • Issues and Trends
      • Regulatory Trends
      • End of Life Doulas
      • Fraud and Abuse
      • Health Care Reform
      • Proprietary Technologies
      • Profitability
      • Payment Rates
      • Managing Opioids in Hospice
    • Market Size and Forecast
      • Cost of Care
      • Size of the Market
        • Table U.S. Hospice Care Market 2016-2023 (in millions $ at manufacturer level)
    • Competitor Analysis
      • Table Leading Competitors in the U.S. Hospice Care Market, by Revenues and % Market Share, 2018
    • Market Analysis
  • Assisted Living
    • Description of Facilities
      • Services
      • Number of Facilities
    • Resident Population
      • Demographic Data
      • Functional Data
      • Length of Stay
      • Insurance Coverage
    • Issues and Trends
      • Economic Issues
      • Industry Challenges
      • Health Care Reform
      • Quality of Care
      • Federal Quality Improvement Initiatives
      • State Quality Improvement Initiatives
      • Safety
      • Mergers and Acquisitions
      • Consumer Knowledge and Information
    • Market Size and Forecast
      • Cost of Care
        • Table Assisted Living Cost Daily, Monthly and Yearly by State, 2017
      • Size of the Market
        • Table U.S. Assisted Living Market 2016-2023 (in millions $)
    • Competitor Analysis
      • Table Leading Competitors in the U.S. Assisted Living Market, by Revenues and % Market Share, 2018
    • Market Analysis
  • Market Summary
    • Overview
    • Issues and Trends
      • Continuum of Care
      • Reimbursement and Regulatory Changes
      • Specialty Care
      • Competitive Bidding
      • Mergers, Acquisitions and Divestitures
    • Market Size and Forecast
      • Table Total U.S. Long-Term Care Market 2016-2023 (in millions$)
      • Table U.S. Long Term Care Market by Segment 2016-2023 (in $ millions)
      • Table U.S. Long Term Care Market 2018 by Segment %
      • Table U.S. Long Term Care Industry Percent (%) by Sector, Selected Years 2016, 2018, 2023
      • Table U.S. Long Term Care Industry Percent (%) by Sector, Selected Years 2016, 2018, 2023
      • Table U.S. Long Term Care Industry Revenues by Sector, Selected Years 2016, 2018, 2023
    • Competitor Analysis
      • Table U.S. Long Term Care Industry Revenues by Major Players 2018 (in $ millions)
  • Company Profiles
    • Almost Family, Inc/LHC Group
      • Table Almost Family/LHC Group Corporate Summary
      • Company Overview
      • Long-Term Care Business
      • Mergers and Acquisitions
      • Corporate Strategies
      • Company Financials
        • Table Almost Family/LHC Group Revenue (2015-2018) ($ millions)
    • Amedisys, Inc.
      • Table Amedisys Corporate Summary
      • Company Overview
      • Long-Term Care Business
      • Mergers and Acquisitions
      • Corporate Strategies
      • Company Financials
        • Table Amedisys Revenue (2015-2018) ($ millions)
    • Apria Healthcare Group, Inc
      • Table Apria Healthcare Corporate Summary
      • Company Overview
      • Long-Term Care Business
      • Mergers and Acquisitions
      • Corporate Strategies
    • Atria Senior Living
      • Table Atria Senior Living Corporate Summary
      • Company Overview
      • Long-Term Care Business
      • Mergers and Acquisitions
      • Corporate Strategies
    • Brookdale Senior Living, Inc.
      • Table Brookdale Senior Living Corporate Summary
      • Company Overview
      • Long-Term Care Business
      • Mergers and Acquisitions
      • Corporate Strategies
      • Company Financials
        • Table Brookdale Senior Living Revenue (2015-2018) ($ millions)
    • Capital Senior Living
      • Table Capital Senior Living Corporate Summary
      • Company Overview
      • Long-term Care Business
      • Mergers and Acquisitions
      • Corporate Strategies
      • Company Financials
        • Table Capital Senior Living Revenue (2015-2018) ($ millions)
    • Extendicare, Inc
      • Table Extendicare Corporate Summary
      • Company Overview
      • Long-Term Care Business
      • Mergers and Acquisitions
      • Corporate Strategies
      • Company Financials
        • Table Extendicare (2015-2018) ($ millions)
    • Five Star Senior Living, Inc
      • Table Five Star Senior Living Corporate Summary
      • Company Overview
      • Long-Term Care Business
      • Corporate Strategies
      • Company Financials
        • Table Five Star Senior Living Revenue (2015-2018) ($ millions)
    • Genesis Healthcare
      • Table Genesis Healthcare Corporate Summary
      • Company Overview
      • Long-Term Care Business
      • Mergers and Acquisitions
      • Corporate Strategies
      • Company Financials
        • Table Genesis HealthCare Revenue (2015-2018) ($ millions)
    • Golden Living Centers
      • Table Golden Living Centers Corporate Summary
      • Company Overview
      • Long-Term Care Business
      • Mergers and Acquisitions
      • Corporate Strategies
      • Company Financials
    • HCR Manor Care, Inc
      • Table HCR Manor Care Corporate Summary
      • Company Overview
      • Long-Term Care Business
      • Mergers and Acquisitions
      • Corporate Strategies
    • Holiday Retirement
      • Table Holiday Retirement Corporate Summary
      • Company Overview
      • Long-Term Care Business
      • Corporate Strategies
    • Home Instead, Inc.
      • Table Home Instead Corporate Summary
      • Company Overview
      • Long-Term Care Business
      • Corporate Strategies
    • Kindred Healthcare, Inc.
      • Table Kindred Healthcare Corporate Summary
      • Company Overview
      • Long-Term Care Business
      • Mergers and Acquisitions
      • Corporate Strategies
      • Company Financials
        • Table Kindred Healthcare Revenue (2015-2018) ($ billions)
    • Kindred at Home
      • Table Kindred at Home Corporate Summary
      • Company Overview
      • Long-Term Care Business
      • Mergers and Acquisitions
      • Corporate Strategies
    • Life Care Centers of America
      • Table Life Care Centers of America Corporate Summary
      • Company Overview
      • Long-Term Care Business
      • Mergers and Acquisitions
      • Corporate Strategies
      • Company Financials
    • Life Care Services LLC
      • Table Life Care Services Corporate Summary
      • Company Overview
      • Long-Term Care Business
      • Mergers and Acquisitions
      • Corporate Strategies
    • Lincare Holdings Inc.
      • Table Lincare Corporate Summary
      • Company Overview
      • Long-Term Care Business
      • Mergers and Acquisitions
      • Corporate Strategies
    • Sunrise Senior Living, Inc
      • Table Sunrise Senior Living Corporate Summary
      • Company Overview
      • Long-Term Care Business
      • Mergers and Acquisitions
      • Corporate Strategies
    • The Ensign Group
      • Table The Ensign Group Corporate Summary
      • Company Overview
      • Long-Term Care Business
      • Mergers and Acquisitions
      • Corporate Strategies
      • Company Financials
        • Table Ensign Group Revenue (2015-2018) ($ millions)
    • Visiting Angels Living Assistance Services, Inc
      • Table Visiting Angels Living Assistance Services Corporate Summary
      • Company Overview
      • Long-Term Care Business
      • Mergers and Acquisitions
      • Corporate Strategies
    • VITAS Healthcare
      • Table VITAS Healthcare Corporate Summary
      • Company Overview
      • Long-Term Care Business
      • Mergers and Acquisitions
      • Corporate Strategies
      • Company Financials
        • Table Vitas Revenue (2015-2018) ($ millions)

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