Supporting Middle Market Senior Housing: Four Financing Solutions

NIC-sponsored Milken Institute research reveals strategies to create and scale properties to meet the needs of aging middle-income Boomers

January 15, 2024

In partnership with Milken Institute

Middle Market  • Research Study

Three quarters of the estimated 16 million ‘middle market’ seniors age 75+ won’t be able to afford senior housing in 2033, with half of those individuals projected to have three or more chronic conditions and potential mobility issues.

The Milken Institute’s Financial Innovations Lab® and Center for the Future of Aging Research shared potential financing and scaling solutions that operators and investors should consider. The work was underwritten through a grant from NIC and CVS Health. Discussions with leaders in healthcare, senior housing and long-term care delivery, finance, technology, government, philanthropy and academia, yielded potential solutions. Ideas to advance solutions for the middle market are summarized in Innovative Financing and Care Models to Scale Affordable Housing Solutions for Middle-Income Older Adults.

In-Depth Resources:


Four strategies to better serve “middle market” seniors:

  1. Repurpose distressed senior living properties through a pilot refinancing/restructuring program
  2. Design a revolving loan fund to provide a sustainable source of capital long-term
  3. Implement a pay-for-performance model that delivers long-term cost savings
  4. Launch a value-based regional pilot partnership between senior housing operators and payers

NIC seeks to educate and convene stakeholders on this critical challenge, laying the groundwork in “The Forgotten Middle,” which appeared in the policy journal Health Affairs in 2019.

2022 NIC Insider Newsletter Chip Gabriel Headshot 200x239“It’s time to put new financing models to the test to create the housing we know more older adults will need.”

Chip Gabriel, NIC board member and Partner, Senior Living TransFormation Company LLC