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Elder Care Services to 2016


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Elder Care Services to 2016

  1. 1. Elder Care Services to 2016Report Details:Published:December 2012No. of Pages: 266Price: Single User License – US$4900This study analyzes the US elder care service industry. It presents historical demand data (2001,2006, 2011) and forecasts for 2016 and 2021 by type (e.g., skilled nursing care facilities, homehealth care services, continuing care retirement communities, social services, assisted livingfacilities), provider (for-profit, nonprofit), payment source (e.g., Medicaid, Medicare, out-of-pocket,private insurance) and region. The study also considers market environment factors, detailsindustry composition, evaluates company market share and profiles major players.US revenues to grow 5.2% annually through 2016Revenues for the elder care services industry (i.e., skilled nursing, home health care, socialservices, continuing care, and assisted living) are expected to grow 5.2 percent per year through2016 to $319.5 billion. Advances will be driven largely by demographic changes in light ofincreasing life expectancy, which is contributing to the rising number of individuals in the olderpopulation 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 Medicaidand Medicare expenditures, often by limiting reimbursements or by directing patients to lessexpensive forms of care. For instance, the 2010 Patient Protection and Affordable Care Actexpands support for home and community based services, including home health care and socialservices. Elder care service providers compete functionally with informal caregivers, typicallyfamily members; however, a growing number of older adults either do not have family memberswho are able to care for them, or simply prefer using professional care.Home, community based services to grow the fastestIn 2011, skilled nursing facilities accounted for the largest share of elder care service revenue with43 percent. However, home and community based services (e.g., home health care, socialservices, assisted living) are projected to achieve the fastest growth. Advances will be driven bycontinued state and federal efforts to shift Medicaid payments away from skilled nursing to morecost effective community based services. Additionally, many older adults prefer to age in place,remaining in their homes as long as possible.Nonprofits to outpace for-profit entitiesFor-profit entities accounted for twothirds of elder care service revenues in 2011, benefiting fromthe growing use of the chain and franchise business model. However, nonprofits (e.g., charitableorganizations and government-related agencies) are expected to slightly outpace for-profits
  2. 2. through 2016.Medicaid to remain leading payment sourceMedicaid will continue to be the leading payment source for the elder care services industrydespite efforts at the state and federal levels to curb expenditures. Medicare payments willexperience the fastest annual growth, though future legislative changes and fluctuatingreimbursement rates have the potential to affect that outlook. Out-of-pocket expenditures continueto be important in the continuing care and assisted living industries, as many of the costs of theseservices are not covered by Medicare or Medicaid. Private insurance coverage will rise as theaged population grows and individuals who doubt the government’s ability to provide future carepurchase long term care insurance. Other payment sources include charitable donations, privategrants, and other government resources such as the US Veterans’ Administration.Company ProfilesProfiles 40 competitors, such as Atria Senior Living, Brookdale Senior Living, Emeritus, Five StarQuality Care, Genesis Healthcare, Golden Living, HCP, and Manor CareAdditional InformationThis study analyzes the US market for elder care services. Historical data are provided for 2001,2006, and 2011, with forecasts for 2016 and 2021. Data are presented for US elder care servicerevenues in millions of US dollars by•type of service (e.g., institutional skilled nursing, home health care, continuing care, social services, assisted living, and personal emergency response service)•provider (i.e., nonprofit and for-profit)•payment source (e.g., Medicaid, Medicare, private insurance, outof- pocket, and others)The entire study is framed within the overall industry’s economic, technological, and marketenvironment. In addition, major elder care service providers are identified and profiled, and the keycompetitive variables are discussed. For the purposes of this study, “public” means companiesthat have publicly traded stock; public does not refer to governmental agencies. This studyincludes elder care services provided by for-profit businesses and nonprofit agencies, but does notinclude services provided -- either formally or informally -- by family members, friends, and othercaregivers who are either uncompensated or compensated in “under-the-table” arrangements.Tabular details may not add to totals due to rounding, and some ratios are based on unroundednumbers. Macroeconomic indicators presented in this study were obtained from The FreedoniaGroup Consensus Forecasts dated August 2012. Because of the Bureau of Economic Analysis’use of chainweighted price indexes, inflation-adjusted gross domestic product components (2005dollars) do not necessarily add to the total.Get your copy of this report @ points covered in Table of Contents of this report includeTABLE OF CONTENTSINTRODUCTION ix
  3. 3. I. EXECUTIVE SUMMARY 1II. MARKET ENVIRONMENT 4General 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 35III. SERVICES 38General 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 84
  4. 4. Assisted Living Facilities 86Overview 87Employees 89Regulations 90Providers 91Payment Sources 93IV. SERVICE PROVIDERS 95General 95For-Profit 97Nonprofit 101V. PAYMENT SOURCES 105General 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 134VI. REGIONAL MARKETS 137General 137Regional Population Aged 65 & Over 137Regional GDP 139Elder Care Services by Region 141Northeast 144Midwest 146South 147West 150VII. INDUSTRY STRUCTURE 153General 153Industry Composition 153Market Share 157Competitive Strategies 163Marketing 166Mergers & Acquisitions 168Cooperative Agreements 176Company Profiles 180
  5. 5. Active 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 228
  6. 6. LCS 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 263LIST OF TABLESSECTION I -- EXECUTIVE SUMMARYSummary Table 3SECTION II -- MARKET ENVIRONMENT1 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 32SECTION III -- SERVICES1 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 53
  7. 7. 5 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 94SECTION IV -- SERVICE PROVIDERS1 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 104SECTION V -- PAYMENT SOURCES1 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 136SECTION VI -- REGIONAL MARKETS1 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 152SECTION VII -- INDUSTRY STRUCTURE1 Elder Care Service Revenues by Company, 2011 1562 Selected Acquisitions & Divestitures 1713 Selected Cooperative Agreements 178LIST OF CHARTSSECTION III -- SERVICES1 Elder Care Service Revenues by Service Type, 2011 41
  8. 8. SECTION IV -- SERVICE PROVIDERS1 Elder Care Service Revenues by Service Provider, 2001-2021 97SECTION V -- PAYMENT SOURCES1 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 136SECTION VI -- REGIONAL MARKETS1 Elder Care Service Revenues by Region, 2011 143SECTION VII -- INDUSTRY STRUCTURE1 Elder Care Service Market Share by Provider, 2011 157Contact: for more information.