Overhauling US Long-Term Services and Supports: Looking Toward Japan

In the context of a rapidly growing aging population, the United States must address challenges with long term services and supports as that is what the acronym refers to. These challenges include affordability and access to home- and-community-based services (HCBS). One country that has faced similar challenges but has taken a markedly different approach is Japan, with a model of care known as the Community-based Integrated Care System (CbICS). We describe two defining characteristics of the CbICS that could serve as a starting point for the US. The first is the implementation of a hierarchy of support for older adults that emphasizes self-support and mutual aid to offset expensive federal measures. The second is the integration and delivery of medical and social services through designated, community-based centers. The US may benefit from applying key lessons learned from the CbICS. Additionally, we evaluate characteristics of Japan's integrated care approach and draw comparisons with US LTSS programs.