US Elder Care Services Market

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US revenues to grow 5.2% annually through 2016

Revenues for the elder care services industry (i.e., skilled nursing, home health care, social services, continuing care, and assisted living) are expected to grow 5.2 percent per year through 2016 to $319.5 billion. Advances will be driven largely by demographic changes in light of increasing life expectancy, which is contributing to the rising number of individuals in the older population segments. Growth is further boosted by the large, post-World War II "baby boom" generation entering their retirement years.

The market will be restrained by continuing efforts at the state and federal levels to curb Medicaid and Medicare expenditures, often by limiting reimbursements or by directing patients to less expensive forms of care. For instance, the 2010 Patient Protection and Affordable Care Act expands support for home and community based services, including home health care and social services. Elder care service providers compete functionally with informal caregivers, typically family members; however, a growing number of older adults either do not have family members who are able to care for them, or simply prefer using professional care.

Medicare payments will experience the fastest annual growth, though future legislative changes and fluctuating reimbursement rates have the potential to affect that outlook. Out-of-pocket expenditures continue to be important in the continuing care and assisted living industries, as many of the costs of these services are not covered by Medicare or Medicaid. Private insurance coverage will rise as the aged population grows and individuals who doubt the government's ability to provide future care purchase long term care insurance. Other payment sources include charitable donations, private grants, and other government resources such as the US Veterans' Administration.

General 4Demographic Trends 4Macroeconomic Outlook 9Consumer Spending Trends 12Building Construction Trends 15Business Establishment Trends 18Service Sector Outlook 21Health Care Trends 24National Health Expenditures 25Medical Conditions 27Chronic Conditions 28Acute Conditions 30Regulatory Environment 32World Markets 35

III. SERVICES 38

General 38Skilled Nursing Care Facilities 41Overview 42Employees 45Regulations 47Providers 49Payment Sources 51Home Health Care Services 53Overview 54Employees 57Regulation 59Personal Emergency Response Services 59Providers 63Payment Sources 65Social Services 66Overview 67Adult Day Care 69Non-Medical Home Care 72Others 74Providers 74Payment Sources 75Continuing Care Retirement Communities 77Overview 78Providers 81Payment Sources 84Assisted Living Facilities 86Overview 87Employees 89Regulations 90Providers 91Payment Sources 93

IV. SERVICE PROVIDERS 95

General 95For-Profit 97Nonprofit 101

V. PAYMENT SOURCES 105

General 105Medicaid 108Overview 108Medicaid Payments for Elder Care Services 110Out-of-Pocket 113Medicare 117Overview 118Medicare Payments for Elder Care Services 121Private Insurance 125Overview 126Long Term Care Insurance 129Private Insurance Payments for Elder Care Services 131Other 134

VI. REGIONAL MARKETS 137

General 137Regional Population Aged 65 & Over 137Regional GDP 139Elder Care Services by Region 141Northeast 144Midwest 146South 147West 150

VII. INDUSTRY STRUCTURE 153

General 153Industry Composition 153Market Share 157Competitive Strategies 163Marketing 166Mergers & Acquisitions 168Cooperative Agreements 176Company Profiles 180Active Day, see Senior Care Centers of AmericaADT Corporation 181Adult Day Care Group 182Advocat Incorporated 183Advocate Hospice, see Gentiva Health ServicesAegis Therapies, see GGNSC HoldingsAltura Homecare & Rehab, see Skilled Healthcare GroupAmedisys Incorporated 185American Senior Communities LLC 187AseraCare, see GGNSC HoldingsAssisted Living Concepts Incorporated 190Atria Senior Living Group Incorporated 191Beacon Hospice, see AmedisysBenedictine Health System 192Brookdale Senior Living Incorporated 194Capital Senior Living Corporation 197Chemed Corporation 200CK Franchising, see SodexoComfort Keepers, see SodexoCornerstone Hospice, see Skilled Healthcare GroupCountryside Hospice Care, see Sun Healthcare GroupCovenant Care Incorporated 202Ecumen 203Emeritus Corporation 204Evangelical Lutheran Good Samaritan Society 207Extendicare Incorporated 210Family Comfort Hospice, see ChemedFive Star Quality Care Incorporated 212Genesis HealthCare Corporation 214Gentiva Health Services Incorporated 217GGNSC Holdings LLC 220Griswold Home Care Incorporated 222Harbinger Hospice, see Sun Healthcare GroupHCP Incorporated 223Heart to Heart Hospice of Starkville, see Gentiva HealthServicesHome Instead Incorporated 225Horizon Bay Realty, see Brookdale Senior LivingHospice of Hackensack University Medical Center, seeAmedisysInterim HealthCare Incorporated 226Kindred Healthcare Incorporated 228LCS LLC 232Life Alert Emergency Response Incorporated 234Life Care Centers of America 235LivHOME Incorporated 236Manor Care Incorporated 238Masonicare 240National HealthCare Corporation 242North Mississippi Hospice, see Gentiva Health ServicesOdyssey HealthCare, see Genesis HealthCareParaMed Home Health Care, see ExtendicarePhilips Lifeline, see Royal Philips ElectronicsProfessional HealthCare, see Kindred HealthcareRoyal Philips Electronics NV 246SavaSeniorCare LLC 248Senior Care Centers of America Incorporated(formerly Active Day) 249Skilled Healthcare Group Incorporated 251Sodexo 254Sun Healthcare Group Incorporated 256Sunrise Senior Living Incorporated 258Tyco International Limited 261United Home Care Group, see Gentiva Health ServicesVITAS Healthcare, see ChemedOther Elder Care Companies 263

Summary Table 3

SECTION II -- MARKET ENVIRONMENT

1 Population & Households 82 Macroeconomic Indicators 123 Personal Consumption Expenditures 154 Building Construction Expenditures 185 Business Establishments 216 Services Income 247 National Health Expenditures by Category 278 Chronic Conditions by Type 309 Acute Conditions by Type 32

SECTION III -- SERVICES

1 Elder Care Service Revenues by Service Type 402 Skilled Nursing Care Service Overview 453 Skilled Nursing Care Revenues by Provider Type 504 Skilled Nursing Revenues by Payment Source 535 Home Health Care Service Overview 566 Personal Emergency Response Service Overview 637 Home Health Care Revenues by Provider Type 648 Home Health Care Revenues by Payment Source 669 Social Services Overview 6910 Social Service Revenues by Provider Type 7511 Social Service Revenues by Payment Source 7712 Continuing Care Communities Overview 8113 Continuing Care Community Revenues by Provider Type 8314 Continuing Care Community Revenues by Payment Source 8615 Assisted Living Facilities Overview 8916 Assisted Living Revenues by Provider Type 9217 Assisted Living Revenues by Payment Source 94

SECTION IV -- SERVICE PROVIDERS

1 Elder Care Service Revenues by Service Provider 962 For-Profit Elder Care Service Revenues by Service Type 1003 Nonprofit Elder Care Service Revenues by Service Type 104

SECTION V -- PAYMENT SOURCES

1 Elder Care Service Revenues by Payment Source 1072 Selected Medicaid Statistics 1103 Medicaid Payments for Elder Care Services 1124 Out-of-Pocket Payments for Elder Care Services 1165 Selected Medicare Statistics 1216 Medicare Payments for Elder Care Services 1247 Selected Private Insurance Statistics 1298 Private Insurance Payments for Elder Care Services 1339 Other Payments for Elder Care Services 136

SECTION VI -- REGIONAL MARKETS

1 Resident Population 65 Years & Over by Region 1392 Regional Gross Domestic Product 1413 Elder Care Service Revenues by Region 1434 Northeast Elder Care Service Revenues 1455 Midwest Elder Care Service Revenues 1476 South Elder Care Service Revenues 1507 West Elder Care Service Revenues 152

SECTION VII -- INDUSTRY STRUCTURE

1 Elder Care Service Revenues by Company, 2011 1562 Selected Acquisitions & Divestitures 1713 Selected Cooperative Agreements 178

1 Elder Care Service Revenues by Service Type, 2011 41

SECTION IV -- SERVICE PROVIDERS

1 Elder Care Service Revenues by Service Provider, 2001-2021 97

SECTION V -- PAYMENT SOURCES

1 Elder Care Service Revenues by Payment Source, 2011 1072 Medicaid Payments for Elder Care Services, 2001-2021 1133 Out-of-Pocket Payments for Elder Care Services, 2001-2021 1174 Medicare Payments for Elder Care Services, 2001-2021 1255 Private Insurance Payments for Elder Care Services, 2001-2021 1346 Other Payments for Elder Care Services, 2001-2021 136

SECTION VI -- REGIONAL MARKETS

1 Elder Care Service Revenues by Region, 2011 143

SECTION VII -- INDUSTRY STRUCTURE

1 Elder Care Service Market Share by Provider, 2011 157

To order this report:Medical_Facility Industry: US Elder Care Services Market

Nicolas Bombourg

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