Surveying the Cost of Care


When is the last time you and your friends talked about the cost of long-term care? It’s not exactly a subject that is going to enliven the evening, or put people in the party spirit. It’s one of those things no-one wants to talk about, but at some point in their lives, a majority of Americans will have a long-term care event.  Planning ahead therefore not only makes sense, it’s a necessity.

Results from the Urban Institute show that 70% of adults who survive to age 65 develop severe long-term services and support (LTSS) needs before they die and 48% receive some paid care over their lifetime.

It’s an open secret that long-term care costs are rising and can impact not only the financial well-being of the person in need of care, but also of their families.

There are many factors to consider – and while people may understand (or think they do!) the difference between nursing home care, assisted living, and care-at-home, they may not have considered that the location of where they expect to access those services will significantly impact their costs.

Factors such as real estate costs, and the cost and availability of labor can vary greatly across the U.S. Where would you guess the most expensive home health aides are to be found? And the most expensive nursing homes?

Problem statement

Without access to data, insurers and their clients are left with just that – guessing. It can be tough to make accurate estimates of actual long-term costs and how they vary by state and type.

And in this subject, as in so many others, the COVID-19 pandemic sent shockwaves across the industry, and had a significant impact on senior care recipients and care providers. Claims from facilities shifted noticeably to home-based care, which accelerated an existing preference by consumers to age at home. Faced with that accelerated trend, home care providers were left scrambling to compete for scarce caregivers, while facilities battled higher costs due to significantly lower occupancy.

Our Solution

We have conducted a proprietary annual cost of care survey since 2013. On an annual basis, we develop and publish our Cost of Care study, which contains detailed national, state and regional cost information on skilled nursing, assisted living, skilled and unskilled home care, and adult day care for 375+ metropolitan areas in the US.

As the largest long term care insurance administrator in the country, illumifin is able to leverage its extensive provider database in order to compile over 36,000 separate data points that inform this study, which is reviewed by our in-house actuarial team.

As a result, we can offer the ultimate resource on cost data in the long-term care industry. Insurers, agents, brokers and providers rely on the Cost of Care study each year to inform their product development, sales, policyholder education and even competitive intelligence efforts.


Consulting illumifin’s detailed study can give insurers and their clients the ability to make decisions about how much long-term care is likely to cost them and where they are most likely to receive it. In addition to serving the industry, we help educate families and distribution channels on the cost of care across care settings and geographies.

For example, Washington’s LTC insurance law passed in 2019 (the first in the nation) requires employers to collect 0.58% of wages through payroll deduction from employees working — or, in certain cases, merely residing — in the state and remit those premium contributions to the state-run LTSS Trust Program.

It was amended in 2021 to allow employees to opt out of the program if they purchased private LTC coverage, and we saw a huge influx of long-term care applications. What our data highlighted to people was that the benefit being offered by the state-run program was nowhere near the real cost of care – and it drove them to purchase their own policies rather than be taxed for something which wouldn’t meet their needs. And there are rumblings that other states may follow suit.

These resources are a valuable way for insurers and financial institutions to communicate the need to plan for long term care costs, helping to simplify complex decisions about coverage options based on the geographic area and care preferences of each individual.

As Americans become increasingly concerned with the cost of senior care, our data has become an essential resource for every financial services company offering products in this space.

And, by the way (if you were wondering) according to our latest data, the most expensive states for home health aides were Minnesota and Washington, whereas Georgia and Florida were the least expensive. Meanwhile, the most expensive nursing home rates were found in Connecticut and New Jersey.

If you used our Cost of Care data, you’d know this, and be able to plan accordingly – and maybe, just maybe, it will give you some snappy facts to impress people at parties.

— Jessica Ferg · Senior Account Manager, Innovative Solutions


of adults who survive to 65 develop LTSS needs