GAO Long Term Care Study
According to the 1999 National Long-Term Care Survey, approximately 7 million elderly had some sort of disability in 1999, including about 1 million needing assistance with at least five activities of daily living.3 Assistance takes place in many forms and settings, including institutional care in nursing homes or assisted living facilities, and home care services. Further, many disabled individuals rely exclusively on unpaid care from family members or other informal caregivers.
Nationally, spending from all public and private sources for long-term care for all ages totaled about $183 billion in 2003, accounting for about 13 percent of all health care expenditures.4 About 69 percent of expenditures for long-term care services were paid for by public programs, primarily Medicaid and Medicare. Individuals financed about 20 percent of these expenditures out of pocket and, less often, private insurers paid for long-term care. Moreover, these expenditures did not include the extensive reliance on unpaid long-term care provided by family members and other informal caregivers. Figure 1 shows the major sources financing these expenditures.
3See Kenneth G. Manton and XiLiang Gu, “Changes in the Prevalence of Chronic Disability in the United States Black and NonBlack Population Above Age 65 from 1982 to 1999,” Proceedings of the National Academy of Sciences of the United States of America, vol. 98, no. 11, (2001). The National Long-Term Care Survey was conducted in 1982, 1984, 1989, 1994, 1999, and 2004, but the 2004 results are not yet available.
4Based on our analysis of data from the Office of the Actuary of the Centers for Medicare & Medicaid Services and The MEDSTAT Group. These figures include long-term care for all people, regardless of age.