The U.S. assisted living facility market was valued at USD 88.04 billion in 2021 and is expected to reach USD 117.96 billion by 2027, growing at a CAGR of 5% from 2022-2027. In the U.S., increased shifting towards independent living by senior/adult older people is delivering high market growth opportunities to assisted living facility market. The significant aging population is increasing the demand for independent living facilities. In 2019, around 92% of the U.S. senior population showed a stabilized occupancy trend for independent living. In recent years, the key players and emerging players have increased their focus on high-end communities, changing the U.S. assisted living facility market landscape.
Assisted living constructions have significantly increased in the past few years, and boosting the market growth, there is an increase in the construction activities related to assisted living community units across the United States. The key companies in the U.S. assisted living facility market are involved in inorganic growth strategies. The merger and acquisition strategies accelerate the AL community’s expansion and geographical presence at the industry level. Further, the new concept of active adult living in the ALF attracts people to it. Even before retirement, people who are about to retire shortly are joining the active living facilities. This is when they have ample cash flow post-retirement; these active living facilities are unique and have better facilities per their requirements. In recent years, this group has been seen as a better target group for the ALF.
In the U.S. assisted living facility market, the regulatory environment surrounding ALF continues to intensify in multiple ways. Local officials, state and federal, are increasingly focusing on enforcing laws and regulations that directly impact assisted living facilities. The higher impact is particularly true for multi-community operators. Some rules and regulations that affect state and local (domestic) laws impact licensure protect the consumer against misleading scenarios, and influence assisted living communities' management, properties, and equipment.
Role of Medicare and Medicaid
Most assisted living communities rely on reimbursement from government funding and programs, such as Medicare and Medicaid, for some of the company's revenues. Medicare and Medicaid do not fully cover assisted living costs or rent, but Medicaid covers the medical expenses at an assisted living facility. Medicare and Medicaid represent some reimbursement helpful for assisted living facilities and seniors who reside in the assisted living facilities.
- More than 28,900 assisted living communities operating in the U.S. Healthcare expenditure by seniors is increased in the United States. In 2020, healthcare expenditure rose to USD 4.1 trillion. This growth is substantially high compared to 2019. In 2022, SeniorLiving.org published a report on assisted living and home care costs in the U.S. In 2022, more than 800,000 American seniors will be living in AL communities.
- The assisted living facilities are undergoing consolidation post-COVID-19 pandemic. Many chains-based assisted living facilities are adding up more ASF or breaking them down into smaller entities to handle operational costs and implement changes faster. Smaller independent assisted living facilities are running the industry changes better than the chain of ALF. Post pandemic, the scenario has changed in the U.S. assisted living facility market; the number of people enrolling in nursing and long-term care facilities is decreasing. However, there is a moderate increase in the number of people registering for the ALF. This number of expected to increase in the future.
- Many U.S.-based assisted living facility organizations are engaged in various innovation initiatives. New technologies, ideas, and operating models to improve assisted living care facilities and enhance resident engagement and experience are being introduced in the U.S. assisted living facility market. With the help of advanced technology platforms such as remote monitoring, telemedicine, and connected devices, ASFs expect to identify solutions to reduced complexity and increased productivity at an affordable cost for people.
INSIGHTS BY GENDER
The U.S. assisted living facility market by gender is segmented into women and men, among which the women segment dominates the industry with a higher market share. The women's segment shows dominance over men's due to the increased preference for assisted living facilities among the age group of 65 and above. In 2021, the women's segment showed dominance over the men's segment, accounting for a 71.33% higher market share in an assisted living facility. Significant factors driving women's preference for assisted living include a greater need for care, independent living preference, and outliving their spouses.
INSIGHTS BY OWNERSHIP
On the basics of ownership, the U.S. assisted living facility market is segmented into independently owned and chain-affiliated assisted living communities. More than half of assisted living communities are chain affiliated. They employ around 300,000 full-time nurses and social workers. Chain-affiliated assisted living communities show dominance over the independently owned, with a market share of 55.33% in 2021. During the forecast period, independently owned assisted living communities accounted for healthy growth. In 2021, the independently owned segment accounted for 44.67%.
INSIGHTS BY AGE GROUP
The U.S. assisted living facility market is segmented by age group into 85 and above, 75 to 84, and 65 to 74 segments. In 2021, the 85 and above age group accounted for a 52.11% higher market share in assisted living facilities in the U.S.The rising prevalence of chronic conditions in the population, specifically Alzheimer's and dementia, and increasing independent living lifestyles among the older population accelerate the industry growth. More than half of assisted living residents are 85 years and above, whereas almost a third are between 75- and 84 years of age.
The U.S. assisted living facility market is segmented into the West, South, Midwest, and Northeast regions. The aging population is one of the significant factors driving the adoption of assisted living facilities in the United States. The west region shows a higher industry dominance due to the most significant number of major assisted living facility units. Many large assisted living communities are widely present in the Western region, driving the region's higher U.S. assisted living facility market growth.
Most assisted living communities (40.8%) are in the western US, with 28% in the South. In the Southern region, Florida has many assisted living facility communities. Florida is home to a higher aging population in the U.S., accounting for 3,926,889 seniors aged 65 and above. This age group has better purchase power in the industry, driving them to choose better facilitated assisted living facilities.
Brookdale Senior Living, Alerislife (Five Star Senior Living), Atria Senior Living, and Enlivant hold a major share in the U.S. assisted living facility market. Due to the company's high geographical presence, expertise, and well-known brand image, they have a better industry share in the United States. The U.S. assisted living facility market is highly competitive due to numerous organizations offering similar services and community-based service programs.
Currently, more than 28,900 assisted living facility providers are available in the U.S. Brookdale Senior Living, Alerislife (Five Star Senior Living), Atria Senior Living, and Enlivant hold a major share in the U.S. assisted living facility market. In 2022, around 2,500 different senior living services providers, including assisted living facilities, were available in the U.S. Based on Brookdale analysis, the occupancy rate of seniors such as assisted living, independent living, and memory care sharply increased in 2022.