Unlocking the Door to Care at Home

The COVID-19 pandemic created a cold hard reality for women and men living in long-term care facilities. The stories were and are horrific. Families could not see their mom, dad, or other loved one for months or, even worse, were not able to be with a parent or grandparent during their last hours of life. The high rates of loneliness and isolation for long-term care residents and family members will never be forgotten.

The future of long-term care is not about reimagining what it could be. That process started years earlier with for-profit companies, investors, and entrepreneurs creating and investing in the future: delivering long-term care services at home. Of course, America will always need long-term care facilities for a subset of patients who require institutionalization. We anticipate these facilities genuinely caring for those too sick to care for themselves and whose impairments are too costly to manage at home.

The federal Medicaid program began the transition towards community-based care years ago. Medicaid spent about eighteen cents out of every long-term care dollar on community-based care service delivery in 1995. Today almost sixty cents of every

Medicaid dollar are dedicated to community-based care. Yet, despite the ongoing Medicaid transition, it lags. The blame cannot be placed on Medicaid or whoever sits in the White House. Instead, a bipartisan Congress has not addressed long-term care since issuing the 1990 Bipartisan Commission on Comprehensive Healthcare (the "Pepper Commission").

As the nation's long-term care crisis escalates, we decided to highlight what is evolving, growing, and in production in the private, for-profit sector. The entrepreneurial opportunities continue to be without boundaries. The investment community and entrepreneurs demonstrate an incredible vision for what is, what can be, and what should be. The strides forward are remarkable but not surprising, as private enterprise can do many things well in the absence of government innovation.

Our report highlights the best of the private sector and entrepreneurship. The vision of these companies, their CE Os, and teams of amazingly brilliant people are the bedrock of the future of long-term care and care at home. So, as you review this report, consider being part of the possible.