Community-Based Care Models Offer Replicable Solutions Enabling Aging in Place

Rising care costs, workforce constraints, and limited access to affordable care options are making it harder for many older adults to get the support they need to remain at home and in their communities. These pressures are especially challenging for older adults who need help with daily activities but cannot afford private-pay care, have limited access to long-term care insurance, and may not qualify for Medicaid until their situation deteriorates significantly. As a result, many older adults and their families fall within a gap between private-pay care they cannot afford and Medicaid-covered long-term care (LTC), a gap that often increases reliance on family caregivers.

As demand for practical, affordable LTC options grows, policymakers and community leaders need more than examples of promising programs; they need to understand the conditions that allow those programs to take root, sustain operations, and adapt to different communities. The AARP Public Policy Institute and ATI Advisory examined those conditions through a landscape review of more than 60 community-based care models and in-depth research and analysis on three selected programs in Arizona, North Dakota, and Texas. Read the full report.

Key Takeaways:

• Many older adults fall in a gap between private-pay long-term care they cannot afford and Medicaid coverage they do not qualify for, a gap often absorbed by family caregivers.
• Community-based care models offer a practical, locally grounded way to help older adults age in place, alongside (not in place of) broader long-term care financing and delivery solutions.
• Drawing on a landscape review of more than 60 programs and profiles of three such programs (Missouri Slope at Home, Christmas in Action, and Neighbors Who Care), this report identifies six domains communities can use to support replicability as they look to create new or expand existing community-based model. Those domains include: 1) a focused service model, (2) workforce and delivery capacity, (3) operational infrastructure, (4) sustainable funding, (5) trusted community relationships, and (6) local fit.
• Successful replication depends less on copying a specific model and more on adapting its core design features to a community’s own needs, partners, workforce, and funding environment.
• Communities do not need a fully built program to get started. Having a focused service that meets clear local needs, trusted partners who understand the community, early investment in sustaining infrastructure, and financing strategies matched to long-term goals can be enough to begin.