Middle Market



The Forgotten Middle:  Middle Market Seniors Housing Study 

This NIC-funded demand study, which was conducted by NORC at the University of Chicago, is the first of its kind and defines American’s large middle-income seniors’ cohort–not only by its demographic characteristics, but its housing and healthcare needs—today and in 2029.  The study includes data, by income cohorts, that capture:

  • level of cognitive impairment 
  • chronic conditions 
  • mobility limitations 

The middle market includes 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.  If policymakers fail to act, aging middle-income earners risk exhausting their savings on long-term care, threatening their financial security and Medicaid’s long-term sustainability.

In addition to providing data to inform housing and healthcare policy, this research offers insights for institutional investors, capital providers and operators. We hope it serves to spark a national discussion among policy makers and private sector entrepreneurs on how housing and services can be provided to the underserved middle-income senior.

The results of The Forgotten Middle:  Middle Market Seniors Housing Study are being initially presented through two briefings:

Health Affairs Policy Forum  

  • April 24, 2019 policy briefing at the Capital Hilton in Washington, DC
  • Release of Health Affairs manuscript by David Grabowski of Harvard University, Caroline Pearson of NORC at the University of Chicago, Charlene Quinn of the University of Maryland and others (to be posted here April 24)
  • Release of two Perspectives articles:
    • John Rowe, Mailman School of Public Health at Columbia University, on “Facilitating Societal Adaptation to Aging”
    • Jennifer Molinsky, Harvard University, on “What Can Be Done to Better Support Aging in Community?”
  • Blog posts by Bob Kramer, Founder and Strategic Advisor, NIC and others
  • Funding for this briefing has been provided by NIC with additional support from the SCAN Foundation, John A. Hartford Foundation, AARP and the AARP Foundation

To learn more, visit the Health Affairs website

NIC Middle Market Investor Summit 

  • May 21, 2019 investor briefing at the Yale Club in New York City
  • Release of full study with an executive summary, detailed charts and interactive tool (to be posted here May 21)
  • Analytic file for further research
  • Funding for this summit has been provided by NIC with additional support from Institutional Real Estate, Inc. (IREI) and Real Capital Analytics (RCA)

To learn more about the study or the above events, contact NIC at middlemarket@nic.org.

Join the Discussion

Together, let’s figure out housing and care options that meet the needs of our middle-income seniors.  

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