About the Compendium
The compendium addresses the urgent need for long-term services and supports (LTSS) financing reform. It compiles over three decades of proposals to help policymakers explore and compare diverse approaches and policy solutions.
Why This Compendium Exists
For over 30 years, policymakers and experts have offered bold ideas to address the growing crisis in long-term services and supports (LTSS) financing. With support from The SCAN Foundation, the LeadingAge LTSS Center @UMass Boston and ATI Advisory created this interactive compendium to bring these ideas together in one place—making it easier than ever to explore, compare, and learn from past and present proposals.
Our Approach
We conducted a comprehensive environmental scan to identify a wide range of LTSS financing proposals—spanning both public and private approaches. Subject matter experts analyzed each proposal’s core components to surface common themes and critical design choices. The result: a powerful tool that enables side-by-side comparisons and deep dives into the mechanics of reform.
What the Data Reveals
While the challenges in LTSS financing remain constant, the urgency has grown. Proposals in the compendium fall into three major categories:
- Legislative reforms for public financing
- Strategies to strengthen the private market
- Think tank and commission reports covering one or both
Despite differences in design, many proposals share key features—like who’s covered, what services are included, how long benefits last, and the balance of public vs. personal responsibility. Our analysis helps illuminate the trade-offs and design decisions that shape each reform model.
How to Use This Resource
Whether you’re a policymaker, researcher, or advocate, this compendium is your one-stop resource for federal LTSS financing reform ideas. Use the interactive search tools to:
- Explore proposals by design component
- Compare public and private financing strategies
- Review summaries and download proposal details
- Access a glossary of key terms and related resources
Get Started
We invite you to:
- Search and compare proposals
- Read detailed summaries and original documents
- Download proposal matrices and text
- Explore the glossary and related resources