The Untapped Market in Senior Care and the Entrepreneurs Ready to Transform It

The middle-income senior population is expanding rapidly, creating both a societal challenge and a major business opportunity. Once overlooked, this segment is now driving demand for innovative solutions, and leaders who balance profitability with social impact will be best positioned to succeed.  

By 2035, older adults (65+) are projected to outnumber children under 18 in the United States. That shift is reshaping industries across the board, but nowhere more urgently than in senior care. Among the most overlooked yet fastest-growing segments is the “forgotten middle,” seniors who earn too much to qualify for Medicaid yet lack the wealth to afford private-pay long-term care. For entrepreneurs and business leaders, this gap presents one of the most consequential opportunities of the next decade.

The overlooked market hiding in plain sight 

For decades, many providers and investors dismissed the middle-income senior population as too narrow or financially unsustainable. The prevailing wisdom was that these individuals would either “spend down” into Medicaid eligibility or lean on family until care became unavoidable. That assumption no longer holds true. Longer life expectancies, limited retirement savings, and escalating healthcare costs have expanded the size and urgency of this group. Today, millions of older adults find themselves without affordable, accessible care options.

The numbers speak for themselves. By the end of this decade, the U.S. Census Bureau projects that nearly one in five Americans will be over 65, a sharp increase from just 13 percent in 2010. A significant portion will fall into the middle-income bracket, creating both a societal challenge and a lucrative business opportunity.

A market ripe for entrepreneurial leadership 

The pressures on middle-income seniors are mounting: rising healthcare expenses, shortages of affordable housing, and limited access to supportive services. These challenges are deeply personal for families, but they also highlight market inefficiencies ripe for entrepreneurial intervention.

Executives and investors have an opportunity to reimagine models of care that are scalable and financially viable. What was once dismissed as a niche problem now represents a multibillion-dollar growth sector. Those who act now can shape the future of senior care while establishing themselves as leaders in a space where demand is only accelerating.

Innovative models emerging across the industry 

Entrepreneurs are already experimenting with approaches designed to serve the middle-income population. Subscription-based senior services are making costs more predictable and manageable for families. Cohousing and alternative housing models are reducing expenses while fostering community and combating isolation. Tiered services allow seniors to pay only for the level of care they need, rather than being locked into all-inclusive packages.

Technology is proving especially transformative. Advances in telehealth, remote patient monitoring, and digital caregiver tools are extending care into the home and making it more responsive to individual needs. These solutions not only reduce operational costs but also help alleviate workforce shortages, one of the most pressing challenges in aging care today.

Building trust through balance 

Success in this market requires more than efficiency. Profitability must be balanced with accessibility if companies want to earn the trust of middle-income seniors and their families. Research consistently shows that sustainable business practices are compatible with strong financial performance. Leaders who align their business models with affordability and transparency will secure long-term growth and credibility in this expanding sector.

Voices shaping the future of care 

Some organizations are already laying the groundwork for a new era of senior care. Aging Compass, for example, helps families in Fort Wayne navigate senior care options through a streamlined, trusted platform. West Health has become a national leader at the intersection of aging and healthcare, driving innovation across policy, research, and scalable models of care. As Shelley Lyford, CEO and Chair of the West Health Institute and the Gary and Mary West Foundation, explains, “The overwhelming aspiration is to age in place, and technology is rapidly expanding the reach and effectiveness of home-based care.”

Building on that vision, West Health continues to shape initiatives that connect policy, clinical practice, and technology. Its work demonstrates how mission-driven approaches can influence systemic change and create scalable models that benefit millions of older adults.

The moment to act 

The growth of the middle-income senior population is both a warning and an invitation. Companies that cling to outdated assumptions risk being left behind, while those willing to innovate have the chance to build enduring businesses that improve lives on a massive scale.

For entrepreneurs, executives, and investors, this is not a peripheral issue. It is a defining opportunity to lead with vision, shape a more equitable system of care, and seize one of the most significant growth markets of our time.

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