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By 2026, the population of Americans age 65 and older will double to 71.5 million. According to a recent study by Metlife, et al., there are five important issues that impact both current and future retirees:

  1. Increased longevity with Americans living longer;
  2. Changing economic factors such as increased health care costs;
  3. A growing skills shortage in many industries;
  4. Different beliefs about work among the aging Baby Boomer generation; and
  5. Financial resources available for retirement.

All five of these factors affect both the ways seniors plan for retirement and the ways that organizations providing services to seniors must respond.

Continuing care retirement communities (CCRCs) represent an important part of the health care industry that addresses the needs of seniors in their retirement years by offering the benefits of a high -quality retirement lifestyle in conjunction with long-term care. In recent years, these organizations have grown in popularity, although they are not for all seniors because of both the financial and health requirements for clients. CCRCs comprise a sector of the health care industry that reduces their dependency on both the Medicare and Medicaid programs. Instead, they depend upon scheduled maintenance fees as well as one-time entrance fees for primary revenue. As a result, financial managers walk a fine line in pricing strategies that both meet state regulations and satisfy the demands of a well-educated cadre of residents. In this article we focus primarily on the issue of the setting of scheduled maintenance fees which, according to many CCRC managers, are a major source of concern for many residents.

In examining this issue, the analysis that follows has been broken down into five parts. First, the changing financial profile of seniors is presented. Second, the structure and geographic distribution of CCRCs is presented. Third, CCRC fee increases, methodologies, and disclosure issues are discussed. Fourth, a case study of Vicar's Landing, a CCRC in Ponte Vedra Beach, Florida, is presented. Finally, a discussion of the issues and conclusions are offered.


Originally published in the Journal of Health Care Finance, 34(3), pp. 55-65.

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