The Forgotten Middle Class Seniors, Residential Assisted Living National Association

How to Serve the “Forgotten Middle Market?”

Although the size of the Middle Market is doubling by 2033, the size of the high income senior population is almost quadrupling. Thus, RALA’s model will be strong for the next 7 years because you can compete.

Brian J. Pinkowski, RALNA President

I recently attended a NIC webinar on “The Forgotten Middle Market.” The Middle Market are those Americans who have too much in financial resources to qualify for government support programs such as Medicaid, but not enough to pay most private pay options for very long.

These people will have to “spend down” their resources to qualify for Medicaid.

Defining the "Forgotten Middle". Seniors' financial resources inform the housing and care options available to them.
While private pay is the preferred model, the Middle Market is expected to double by 2033 (7 years from now), and account for 44% of the age 75+ population.
Size of the senior population 2018 and 2023, age 75+ by income. The number of middle-income seniors will increase to 15.9 million by 2033.

As a result, there is a big push amongst the larger institutions and investors to push government to help the Forgotten Middle Market pay for care. 

The average price of assisted living and out of pocket medical costs is $65,000.00, and an estimated 9.6 million seniors can pay for this.

However, if the price of care drops to $55,000.00, there are an additional 2.2 million seniors that can afford their care needs.

An additional 4.3 million seniors can afford care if the annual price of care is $45,000.00.

The big boxes are looking at ways to provide that stripped down level of care to meet these market demands. And they are looking at programs like PACE to pick up the slack as services are streamlined.

What does this mean for RALs?

Although the size of the Middle Market is doubling by 2033, the size of the high income senior population is almost quadrupling. Thus, RALA’s model will be strong for the next 7 years because you can compete.

Alternatively, if you are targeting the Forgotten Middle, you will be involved with an important social issue, and will very likely be getting involved in creative finance.

The information herein is intended to be educational and an introduction to the subject matter presented. Despite any statutory or regulatory references cited in the article above, it is NOT specific legal advice to be relied upon for specific individual circumstances. Contact your own legal professional or reach out to our firm if you would like specific advice on this topic.

Look for additional blog posts on topics of interest to Assisted Living, Group Homes, and Behavioral Health operators. We welcome topic suggestions! Write to [email protected] if you are curious to learn more about a certain topic impacting assisted living or other group housing concerns.

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