Why Long-Term Care Needs an Intelligence Hub
Several months ago, I was sitting at my laptop with three browser tabs open. At the time, I was researching what would later become three reports on artificial intelligence and the home care industry.
Tab one announced a new AI tool for health care, promising much but thin on evidence. Tab two described yet another proposed change to Medicaid policy. Tab three presented a labor-market analysis on the ongoing direct-care worker shortage.
On the surface, they had nothing in common. Yet I realized that they were all telling the same overarching story: demand for long-term care is growing faster than our ability to provide it, legislate it, and especially understand it. According to PHI, more than 9.7 million direct care jobs will need to be filled between 2024 and 2034—a vast undertaking, given how little these jobs pay and how rarely workers stay in them beyond 90 days.
Technology is evolving because the home care workforce is under strain, and tech innovators believe they can help solve it—and let’s be honest, cash in along the way. Policymakers are seeking new ways to finance long-term care services amid changing demographics, turmoil in Medicaid policy, and strained state budgets. They are paying more attention to family caregiving because their employees are increasingly trying to balance work and home responsibilities, and it’s not going well for them, especially women, who shoulder the burden of family caregiving.
Multiple tabs open, that moment stayed with me, encapsulating what I’ve noticed for over 15 years: one of the hardest parts of working in the long-term care field isn’t simply finding information—it's making sense of it and not drowning in the ocean of information overload.
Information Without Insight
Every week brings another report or article worth reading. Researchers publish new evidence on dementia. States experiment with workforce policies. Congress debates Medicaid. Employers expand caregiving benefits. Startups introduce new technologies. Foundations launch initiatives. Health systems announce partnerships.
For anyone working or invested in this field, there has never been more knowledge at our fingertips. There has also never been a greater challenge in deciding what deserves our attention.
The rapid expansion of digital media and information, which can blur the line between credible journalism and deeply biased misinformation and disinformation, exacerbates this overconsumption problem.
Earlier in my career, I believed staying informed meant reading more. I had file folders in both print and digital forms. I set aside several hours a week to read and take detailed notes. I had been educated as a journalist and spent most of my career leading policy advocacy, research, and strategic communications departments, all of which required a precise, thorough sense of both the latest happenings and their contextual history.
Later, I thought it meant engaging more experts—and that effort was unyielding.
However, after working with providers, policymakers, researchers, advocates, employers, technology companies, and philanthropies, I realized neither approach was enough.
Each one of those communities sees an important part of the picture. Few have the time, or the incentive, to step back and ask how the pieces fit together. Yet that is increasingly where the most interesting insights emerge.
Artificial intelligence is a good example. It might look like a technology story, but it is also about the workforce, autonomy, privacy, a lack of government safeguards, Medicaid reimbursement, aging, disability, and trust. The same could be said for immigration, housing, demographic change, or family caregiving.
Increasingly, the issues shaping long-term care don’t stay neatly within their own lanes. Our country spends more than $400 billion annually on nursing home and home health care, yet these services remain fragmented, costly, and difficult to navigate. By the same reasoning, how could one stay on top of its many dimensions, which change routinely?
That has changed what leadership requires. Not long ago, a leader could spend most of their time focused on provider operations, workforce issues, and Medicaid policy. Today, that same leader may also need to understand venture investment, labor markets, consumer expectations, housing, artificial intelligence, employer benefits, and public opinion. They could also follow a few trusted news outlets, but that level of reading and parsing of information is remarkably time-consuming.
Introducing The CareWorks Dispatch
Most long-term care ecosystem leaders I speak with say they need a better way to identify patterns and distinguish meaningful signals from the constant stream of news. They want to connect developments that appear unrelated until they step back and look at the whole landscape. They want the microscope and the drone.
This is why, over the past few years, I’ve begun thinking of a solution: an intelligence hub. Not because long-term care lacks smart people—in fact, it overflows with expertise. What’s harder to find is a centralized place that consistently scans across disciplines, connects ideas rarely discussed together, and helps leaders make sense of trends before their implications become obvious.
While large corporations often invest in strategic foresight, competitive intelligence, or market analysis, most organizations in long-term care and adjacent fields don’t have this luxury. Their attention must be on serving people, supporting workers and care recipients, managing organizations, responding to policy changes, and solving immediate problems. As a result, there’s little time left to look at the horizon.
Yet the horizon matters: the biggest changes rarely announce themselves all at once. Leaders who spot these patterns early have more time to adapt, ask better questions, and lead rather than react.
That instinct is what led me to createThe CareWorks Dispatch, a curated, quarterly e-intelligence briefing on long-term care from The CareWorks Project.
This newsletter won’t summarize everything happening in long-term care, which would be impossible. Instead, it will curate what our CareWorks team of experts believes matters most, connect ideas that rarely appear in the same conversation, and explain why they deserve your attention.
Some months, we’ll explore a new technology. Other times, we’ll look at an overlooked policy development, a demographic shift, a business innovation, or a field of research that could change how this field thinks about the future. We’ll often explore controversial subjects because those, too, merit attention. Whatever the topic, we’ll come back to the same question that began with those three browser tabs:
What larger story is this issue or development telling?
If this newsletter does its job, you’ll leave each issue with a clearer picture of where the field is headed, why it matters, and what may be worth watching next.
Join us as The CareWorks Dispatch becomes your go-to source for exactly that.
Subscribe here: https://www.careworksproject.co/careworks-dispatch
Learn more about The CareWorks Project: https://www.careworksproject.co/
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The CareWorks Project is an advisory and innovation studio helping leaders reimagine care in today’s economy. We partner across sectors to strengthen long-term care systems so people can live with dignity, workers can thrive, and communities can rely on care that works. A future that honors the people who give and receive care is within our reach.
Robert Espinoza is Founder and CEO of The CareWorks Project, where he helps leaders rethink how long-term care, aging, and workforce systems are designed in a rapidly changing world. For more than 25 years, he has been a nationally recognized strategist, working across the public, private, and philanthropic sectors to develop solutions that strengthen long-term care, support workers, and improve economic opportunity. Robert previously served as CEO of the National Skills Coalition, Executive Vice President of Policy at PHI, and a Nonresident Senior Fellow at Brookings Institution.
He is a Leadership & Society Fellow at the University of Chicago, a board member of the FrameWorks Institute, and a widely published author, speaker, and advisor on the care economy and the future of long-term care.