United States Long Term Care - Market Share Analysis, Industry Trends & Statistics, Growth Forecasts (2026-2031)

The united states long term care market size is projected to expand from USD 567.45 billion in 2025 and USD 610.86 billion in 2026 to USD 883.10 billion by 2031, registering a CAGR of 7.65% between 2026 to 2031. This report is Segmented by Service (Home Healthcare, Hospice, Nursing Care, Assisted Living Facilities, Adult Day-Care Centers), Payer (Public, Private Insurance, Out-of-Pocket/Self-Funded, Managed-Care & Value-Based Contracts), Age Group (0-29 Years, 30-64 Years, 65-74 Years, 75-84 Years, 85 Years & Above). The Market Forecasts are Provided in Terms of Value (USD).

United States Long Term Care Market Trends and Insights

Aging Population and Longevity Driving Structural Demand Expansion

The demographic base supporting the United States long term care market is expanding faster than most provider planning cycles and capital budgets can adjust. The population aged 65 and older reached 61.2 million in 2024, represented 18.0% of the U.S. population. By 2024, 11 states and nearly 45% of U.S. counties had more older adults than children, which shows how quickly this age shift has spread across local care markets. Brookings reported that nearly 1 in 5 adults aged 65 and older could not perform at least 1 activity of daily living, while the figure approached 2 in 5 among those aged 85 and older, which is a direct trigger for formal long term care use. As this aging pattern spreads across Sun Belt states and rural counties at the same time, the United States long term care market faces a location mismatch between existing facilities and the counties where demand is rising most quickly, and that gap will take years to close because development, licensing, and staffing all move slowly.

Medicaid and Medicare HCBS Rebalancing Reshaping Service Architecture

The shift from institutional care toward home and community-based care is now built into how the United States long term care market deploys funding, capacity, and care coordination. In 2023, 87% of 9.7 million Medicaid LTSS users received HCBS, and HCBS accounted for 63.8% of total LTSS spending of USD 228.6 billion, which confirms how far service delivery has already moved away from institutional models. All but 11 states used managed care for at least some home care delivery, and 26 states included 1915(c) waivers under managed care arrangements in 2025, up from 22 states in 2024, which shows that MLTSS adoption is still advancing. This policy direction is reinforcing demand for home care, adult day care, and other community-based formats while also changing how providers in the United States long term care market invest in documentation, network participation, and outcomes management. KFF projected that the 2025 reconciliation law will reduce federal Medicaid spending by USD 911 billion over 10 years, and because HCBS programs are optional, states may respond by tightening enrollment or lowering reimbursement if budget pressure deepens. CMS also finalized the 2028 HCBS Quality Measure Set with mandatory reporting beginning in fall 2026, which creates added compliance work that will weigh more heavily on smaller HCBS providers with limited technology infrastructure.

Direct-Care Workforce Shortages Constraining Supply-Side Capacity

Workforce availability remains the clearest operating restraint across the United States long term care market because labor demand is growing faster than new worker supply. PHI projected 8.9 million direct-care job vacancies between 2024 and 2034, including roles created by growth, turnover, and labor force exits. PHI also reported that home care alone will face 6.1 million job openings by 2034, after the home care workforce expanded from 1.4 million in 2014 to 3.2 million in 2024. ANCOR reported in 2025 that 88% of community-based providers were experiencing moderate or severe staffing shortages, 62% had turned away referrals because of inadequate staffing, and 52% were considering additional program cuts if conditions did not improve. PHI further reported that the median hourly wage for home care workers was USD 16.77 in 2024, with 15% living below the poverty line and more than 40% living in low-income households, which shows that the constraint extends beyond pay and into job quality, career mobility, work hours, and benefits.

Other drivers and restraints analyzed in the detailed report include:

• Aging-in-Place Preference Creating Durable Uplift for Home-Based Services
• Chronic Disease and Dementia Burden Raising Per-Beneficiary Intensity
• Wage Inflation and Reimbursement Lag Compressing Provider Margins

For complete list of drivers and restraints, kindly check the Table Of Contents.

Segment Analysis

Home Healthcare held 45.31% of the United States long term care market share in 2025, which reflects the strength of community-based delivery, public HCBS funding, and family preference for care at home. Richmond Fed reported in January 2026 that CMS programs reimburse more than 50% of total U.S. home health expenditures, and Medicaid accounted for nearly two-thirds of home care spending in 2023, which confirms the segment’s deep public funding base. Nursing Care and Assisted Living Facilities remained the next largest service groups, but they are moving in different directions within the United States long term care market. Nursing care faces gradual pressure in lower-acuity cases because more families prefer to delay institutional placement and use home-based services first. Assisted living is benefiting from seniors who need daily supervision but not full clinical intervention, and Brookdale management said average occupancy was tracking toward 90% in 2026, which signals steady demand recovery in that setting.

Adult Day-Care Centers are projected to grow at an 9.38% CAGR between 2026 and 2031 within the United States long term care market size. That pace stands 173 basis points above the overall market growth rate and reflects the segment’s role as a supervised bridge between home care and full institutional admission. CareScout reported that the national median daily rate for adult day health care was USD 95 in 2025, which supports its value case for families and public programs seeking lower-cost care intensity. The segment also fits closely with HCBS waiver structures and state efforts to prevent institutional admission, which supports continued demand as care continues to move into community settings across the United States long term care industry. Hospice remained smaller in revenue share, but it retained solid margin potential as the 85+ population expanded and palliative care acceptance broadened.

Complete Report Scope:

• By Service
  • Home Healthcare
  • Hospice
  • Nursing Care
  • Assisted Living Facilities
  • Adult Day-Care Centers
• By Payer
  • Public
  • Private Insurance
  • Out-of-Pocket / Self-Funded
  • Managed-Care & Value-Based Contracts
• By Age Group
  • 0-29 Years
  • 30-64 Years
  • 65-74 Years
  • 75-84 Years
  • 85 Years & Above

List of Companies Covered in this Report:

• AccentCare
• Addus HomeCare
• Atria Senior Living
• Aveanna Healthcare
• BAYADA Home Health Care
• Brookdale Senior Living
• Discovery Senior Living
• Diversicare Healthcare Services
• Erickson Senior Living
• Gentiva
• Home Instead Inc.
• LCS
• National HealthCare Corporation
• Sonida Senior Living
• Sunrise Senior Living
• The Ensign Group
• The Pennant Group
• VITAS Healthcare

Additional Benefits:

• The market estimate (ME) sheet in Excel format
• 3 months of analyst support