By Sarita Mohanty, Forbes Councils Member.
“If I could, I would love to be home.” That’s how many older adults describe their hoped-for vision of life five years down the road. But many also wonder whether it’s a vision that can come true, given the high costs of healthcare and long-term care, a lack of accessible amenities, and even the challenges of caring for their own aging parents.
Business leaders know their companies are more successful and more profitable when they listen to their customers. But all too often, the U.S. healthcare system isn’t guided by the same “customer first” principles that would prioritize meeting these hopes and dreams for aging well. And the truth is, this neglect is costing our economy to the tune of billions of dollars every year.
In total, 88% of older American adults (ages 50 to 80) say it is important to “age in place”—but only 19% are “very confident” they can afford personal and home services when they need them. Conversely, more than 40% of Americans have little or no confidence in their ability to age in place. Even these figures should be interpreted with caution, given research showing that many older adults are overly optimistic about their ability to outlive their financial resources.
All of which underscores the importance of the wide range of programs and supports that enable older Americans to remain at home and in their local communities rather than in a nursing facility or other institution. Many lower-income Americans rely on services offered through Medicaid’s home and community-based services (HCBS) program, such as home healthcare, personal care, adult daycare, home-delivered meals and transportation. These services have been important for allowing more older Americans to live the lives they want with better health and quality of life.
The Business Case For Offering Senior Services
That’s the moral case for these services, but there is also a strong business case. When older Americans can’t find affordable home- and community-based services, family members who must step in to care for their loved ones often miss work and even leave the workforce. A 2025 study found that the loss of earnings due to unpaid family care for older adults in the U.S. is currently $107 billion per year and could grow to $380 billion by 2060. The costs of lost productivity associated with unpaid family care are expected to grow from $26 billion to $102 billion in the same period.
Home- and community-based services are also an increasingly important and growing sector of the U.S. economy, with the home care workforce expected to grow by 6.1 million job openings in the coming decade. In 2022, spending on these services totaled $284 billion, with Medicaid paying for 61%.
Research shows these services deliver an impressive return on investment. In fact, every dollar spent on home and community-based services saves money we might otherwise spend on more expensive institutional care. One analysis shows savings of more than $3 for every $1 spent on key services that support older Americans to age in place.
So if home and community-based services are beneficial in so many ways, why is funding for these services at risk? One reason is because the federal government does not require Medicaid coverage for most of these services, even as coverage for institutional care in nursing facilities is mandatory. As a result, older Americans’ access to home- and community-based services is uneven; for example, the waitlist for access to Medicaid HCBS services has grown to roughly 700,000 people. The situation is unlikely to improve with the enactment of H.R. 1 earlier this year, which will cut Medicaid spending by an estimated $911 billion over the coming decade.
How Businesses Can Support Workers
At a time when more Americans want and need these services, business leaders can play a vital role in assuring that more older adults are able to fulfill their desire to age in place. Here are a few steps to consider:
• Advocate for solutions. One major solution we can fight for is a comprehensive long-term care system that supports older Americans to stay at home and in their communities. Business leaders can help make the case for solutions to policymakers, the media and the public. One key talking point: When workers have to step in to care for family members and loved ones who aren’t getting the services and care they need, it’s workers and their employers who pay the price.
• Track and share the impact of these issues on your business. Begin to track how the lack of support for home and community-based services is affecting your employees and bottom line. How are caregiving responsibilities for older adults affecting your workers? Are there discernible impacts on productivity, employee retention, worker hours and revenue? Can you gather stories showing how this issue is affecting individual workers and their families?
• Support employees to find caregiving solutions. If your company has an employee assistance program (EAP) benefit for employees, let them know that EAPs can help them understand options for caregiving for older parents. If you don’t have an EAP, consider creating one. At the very least, companies can share helpful resources with employees on how and where to find quality caregiving support.
• Consider making changes in leave policies. Some paid leave policies cover time off for family caregiving emergencies. Check what your company provides, and consider changes that will help your employees address their families’ short-term needs and find peace of mind.
All of us have a stake in making sure older Americans and people with disabilities are getting the care and support they want and need to age well and live lives of dignity. This is an issue with profound effects on families, communities and businesses. Let’s work together to support families and local and regional economies. Promoting healthy aging isn’t just a moral choice; it’s a choice that can deliver economic benefits for all of us.