France Long Term Care Market Overview, 2031

Key Insights

• France's long-term care market is one of the largest and most established in Europe, anchored by a comprehensive public financing system through the Branche Autonomie. At the beginning of 2025, 14.9 million people residing in France were aged 65 or over, representing 22% of the population. This proportion places France at the average level of the European Union.
• The number of dependent elderly people in France is projected to increase significantly. According to INSEE projections, the number of dependent elderly people will rise from 2.7 million in 2025 to 3.6 million in 2050. The Drees estimates that by 2050, France will have between 2.6 million and 3 million dependent seniors, with an additional 738,000 dependent seniors to be supported by 2050.
• The French long-term care infrastructure comprises approximately 7,500 EHPAD (Établissements d'Hébergement pour Personnes Âgées Dépendantes) with a total of 615,000 places. The sector is characterized by a mixed economy: 48% public, 29% associative (non-profit), and 23% private commercial.
• The home care sector is experiencing significant growth, driven by the strong preference of French seniors to age in place. The number of people at home needing assistance with autonomy is projected to rise from 1.49 million in 2025 to 1.85 million in 2035. The home care offer comprises approximately 9,000 SAAD (Services d'Aide et d'Accompagnement à Domicile) and 2,159 SSIAD (Services de Soins Infirmiers à Domicile).
• France's long-term care financing is substantial and growing. The Branche Autonomie (Autonomy Branch) of social security has an objective of €33.25 billion in expenditure for 2025, a 5.4% increase compared to 2024. Of this, €17.538 billion is allocated to structures supporting dependent elderly people.

Market Outlook

• According to the research report, "France Long Term Care Market Overview, 2031," published by Bonafide Research, the France Long Term Care Market is anticipated to grow at more than 5.3% CAGR from 2026 to 2031. This growth is supported by accelerating demographic aging, the expansion of home care services, and ongoing policy reforms aimed at strengthening the autonomy sector.
• France's demographic trajectory is a primary driver of long-term care demand. At the beginning of 2025, 22% of the population was aged 65 or over. In 2025, France recorded a negative natural balance for the first time since the end of the Second World War, with more deaths than births. The share of seniors aged 65 or over is now almost the same as that of those under 20. According to INSEE projections, the number of dependent elderly people will rise from 2.7 million in 2025 to 3.6 million in 2050.
• The demand for home care services is expected to significantly outpace supply. The number of people at home needing assistance with autonomy will rise from 1.49 million in 2025 to 1.85 million in 2035. The French government is implementing a major reform of home care services, merging SAAD, SSIAD, and SPASAD into unified Services Autonomie à Domicile (SAD) to restructure the offer of home help and care services.
• The EHPAD sector faces significant challenges. While the number of places has grown, the concentration of the private sector is increasing. The 15 largest private groups now account for 81% of commercial beds, compared to 30% 25 years ago. The five largest groups Clariane, DomusVi, Emeis, Colisée, and Domidep concentrate 85,600 beds, representing two-thirds of the commercial park.
• Public spending on long-term care is growing substantially. The Branche Autonomie's expenditure objective for 2025 is €33.25 billion, a 5.4% increase from 2024. Expenditures are expected to increase by 6.7% at constant scope in 2025. The French government is actively working on long-term care reform, including the development of a fifth branch of social security dedicated to autonomy.

Market Dynamics

Driver: Accelerated Demographic Aging and Rising Dependency France is experiencing a profound demographic transformation that is fundamentally reshaping the long-term care landscape. At the beginning of 2025, 14.9 million people residing in France were aged 65 or over, representing 22% of the population. The share of seniors has increased by 5 percentage points in 20 years. In 2025, France recorded a negative natural balance for the first time since the end of the Second World War, with more deaths than births. The share of seniors aged 65 or over is now almost the same as that of those under 20. According to INSEE projections, the number of dependent elderly people will rise from 2.7 million in 2025 to 3.6 million in 2050, with a "wall" expected as early as the 2030s. The Drees estimates that by 2050, France will have between 2.6 million and 3 million dependent seniors. The number of strongly dependent seniors will increase by 44% by 2050, simply because seniors are aging: in 25 years, 19% of seniors will be over 85, compared to 13% in 2021. The female share of the population increases with age due to their greater longevity: 52% at age 65, 61% at age 85, and 76% at age 95.

Challenge: Workforce Shortages and Capacity Constraints France's long-term care market faces a persistent workforce crisis that threatens service availability and quality. The Drees estimates that between 150,000 and 200,000 additional caregivers will be needed by 2050 to support the growing number of dependent seniors. The EHPAD sector faces significant recruitment challenges, with the average age of care workers increasing and the profession suffering from a lack of attractiveness. The home care sector also faces workforce shortages, with low wages and difficult working conditions contributing to high turnover. The concentration of the private EHPAD sector has increased, with the 15 largest private groups now accounting for 81% of commercial beds, compared to 30% 25 years ago. The independent sector, formerly 70% of the market, now represents only 19%. Without significant investment in workforce recruitment, training, compensation, and career development, France's long-term care system will face increasing difficulty in meeting growing demand for care.

Trend: Shift Toward Home Care and the "Virage Domiciliaire" A fundamental shift in long-term care delivery is occurring in France, with services increasingly being delivered in home-based settings rather than institutional facilities. The number of people at home needing assistance with autonomy is projected to rise from 1.49 million in 2025 to 1.85 million in 2035. The home care offer currently comprises approximately 9,000 SAAD (Services d'Aide et d'Accompagnement à Domicile) and 2,159 SSIAD (Services de Soins Infirmiers à Domicile). The Institut Santé report recommends reversing the current model, which still relies too heavily on EHPAD, with a target of 75% home care and 25% institutional care by 2050, compared to the current 60/40 split. The reform of home care services, merging SAAD, SSIAD, and SPASAD into unified Services Autonomie à Domicile (SAD), is being implemented to restructure the offer of home help and care services. This trend is driven by the strong preference of French seniors to age in place, as well as the potential for cost savings compared to institutional care.

Policies

• The Branche Autonomie (Autonomy Branch) of social security, established under the law of August 7, 2020, is the cornerstone of France's long-term care financing. For 2025, the expenditure objective is €33.25 billion, a 5.4% increase compared to 2024. Of this, €17.538 billion is allocated to structures supporting dependent elderly people. Expenditures are expected to increase by 6.7% at constant scope in 2025.
• The Allocation Personnalisée d'Autonomie (APA) is the primary benefit for dependent elderly people in France. It is granted by departmental councils to people aged 60 and over who have lost their autonomy. APA is a universal benefit, awarded without resource conditions but subject to a financial contribution from the beneficiary, calculated according to their income. In 2025, maximum monthly amounts vary between €2,045.56 and €797.96 depending on the GIR (level of dependency). Women and the most modest retirees are the main beneficiaries of APA.
• The law "Bien vieillir" (Well Aging) of 2024 reinforced controls and transparency of EHPAD establishments following the Orpea scandal in 2022. Since September 2025, the Qualiscope platform (HAS) allows the public to consult the quality ratings of each EHPAD free of charge.
• The reform of home care services is being implemented, merging SAAD (Services d'Aide et d'Accompagnement à Domicile), SSIAD (Services de Soins Infirmiers à Domicile), and SPASAD (Services Polyvalents d'Aide et de Soins à Domicile) into unified Services Autonomie à Domicile (SAD) to restructure the offer of home help and care services.
• The Loi de Financement de la Sécurité Sociale (LFSS) for 2025 provides for the autonomy branch to reach a near-balance situation (-0.4%). The budget for the autonomy branch in 2025 is €42.4 billion. The government has announced an additional €300 million for EHPAD budgets.
• France has requested assistance from the European Union for long-term care reform, including support for the development of home care services and the training of care workers.

Segment Analysis

France Long-Term Care Market By Service Type • Home Healthcare: Home healthcare represents the fastest-growing service segment in France's long-term care market, driven by the strong preference of French seniors to age in place and government policies promoting home-based care. The number of people at home needing assistance with autonomy is projected to rise from 1.49 million in 2025 to 1.85 million in 2035. The home care offer comprises approximately 9,000 SAAD and 2,159 SSIAD. The reform of home care services, merging SAAD, SSIAD, and SPASAD into unified SAD, is being implemented to restructure the offer. Home healthcare includes personal care, nursing care, and support services delivered in the patient's home. The segment is supported by the APA, which finances home care for dependent elderly people.
• Nursing Care / Skilled Nursing Facilities: The nursing facility sector in France comprises approximately 7,500 EHPAD with a total of 615,000 places. EHPAD provide accommodation and care for dependent elderly people, including 24-hour nursing care, medical supervision, and personal assistance. The sector is characterized by a mixed economy: 48% public, 29% associative (non-profit), and 23% private commercial. The sector faces significant capacity constraints, with growing demand and workforce shortages limiting supply growth. The five largest private groups Clariane, DomusVi, Emeis, Colisée, and Domidep concentrate 85,600 beds.
• Assisted Living Facilities: Assisted living facilities, including résidences autonomie, represent a growing segment of France's long-term care market. There are 2,182 résidences autonomie with 112,002 places. These facilities provide accommodation and services for seniors who are still autonomous but require some assistance. The segment is supported by government policies promoting independent living and home adaptations. The 2025 Disabled Facilities Grant has been increased to support home adaptations for disabled and elderly people.
• Hospice and Palliative Care: Hospice and palliative care services in France are delivered across multiple settings, including homes, EHPAD, hospitals, and dedicated palliative care units. The Atlas des soins palliatifs et de la fin de vie published by the CNSPFV recenses 8,666 dedicated palliative care beds in 2025, representing a density of 12.5 beds per 100,000 inhabitants. The growing prevalence of chronic conditions and increasing life expectancy are driving demand for palliative care services. The segment is supported by the development of palliative care units in hospitals and EHPAD.
• Other Services: This segment includes day care facilities (accueils de jour), respite care, and short-term stays in EHPAD. Day care facilities provide social engagement and support for older adults, supporting the preference for home-based care. Respite care services provide temporary relief for family caregivers. The need for these services is growing as families seek alternatives to full-time institutional care while maintaining their caregiving responsibilities.

France Long-Term Care Market By Payer Type • Public: Public sources are the dominant payer for long-term care services in France. The Branche Autonomie (Autonomy Branch) of social security has an expenditure objective of €33.25 billion for 2025. Of this, €17.538 billion is allocated to structures supporting dependent elderly people. The APA (Allocation Personnalisée d'Autonomie) is the primary benefit for dependent elderly people. The CNSA (Caisse Nationale de Solidarité pour l'Autonomie) manages the financing of the autonomy sector. Public payers represent both the largest and fastest-growing payer segment.
• Private: Private sources account for a significant portion of long-term care spending in France. The private commercial sector accounts for 23% of EHPAD beds. Private health insurance and complementary pension schemes cover a portion of long-term care costs. The development of private long-term care insurance is being encouraged by the government to complement public financing.
• Out-of-Pocket: Out-of-pocket payments represent a substantial component of long-term care spending in France. The average cost of an EHPAD in France is between €2,300 and €2,400 per month in 2025, with significant regional variations from €2,060 per month in the Meuse to €4,500 per month in Paris. The average cost for a person in GIR 5 or 6 is €2,645.77 per month. For individuals in EHPAD, the cost of accommodation and care is partially covered by the APA and social assistance, but significant out-of-pocket costs remain.

France Long-Term Care Market By Gender • Female residents account for the largest share of France's long-term care spending, driven by higher life expectancy and higher rates of disability in advanced age. The female share of the population increases with age due to their greater longevity: 52% at age 65, 61% at age 85, and 76% at age 95. Women are more likely to live alone in old age at age 85, 54% of women live alone in ordinary housing, compared to 25% of men. Women are the main beneficiaries of the APA. Women also dominate the long-term care workforce, with the majority of care workers being female.
• Male residents account for a smaller but growing share of France's long-term care spending. Men live predominantly as couples in ordinary housing: 72% at age 65 and still 65% at age 85. Living as a couple favors their maintenance at home. Men are more likely to need long-term care at younger ages due to disabilities and chronic conditions. As male life expectancy increases, the representation of men in the older adult cohort is slowly growing.

France Long-Term Care Market Economics

• The cost of long-term care services varies significantly by service type, geographic location, and facility status. The average cost of an EHPAD in France is between €2,300 and €2,400 per month in 2025, with regional variations from €2,060 per month in the Meuse to €4,500 per month in Paris. The average cost for a person in GIR 5 or 6 is €2,645.77 per month. EHPADs in large private groups cost on average €8 more per day than other private EHPADs.
• Public financing of long-term care is substantial and growing. The Branche Autonomie's expenditure objective for 2025 is €33.25 billion, a 5.4% increase from 2024. Expenditures are expected to increase by 6.7% at constant scope in 2025. The APA is the primary benefit for dependent elderly people, with maximum monthly amounts varying between €2,045.56 and €797.96 depending on the GIR.
• Staffing costs represent the largest operating expense for all long-term care providers. The sector faces significant workforce shortages, with the Drees estimating that between 150,000 and 200,000 additional caregivers will be needed by 2050. Low wages and difficult working conditions contribute to high turnover and recruitment challenges.
• The economic value of home- and community-based services relative to institutional care is a key policy consideration. The Institut Santé report recommends a target of 75% home care and 25% institutional care by 2050, compared to the current 60/40 split. Home care is generally less expensive than institutional care on a per-patient basis, and the shift toward home care is expected to continue.


Considered in this report
• Historic Year: 2020
• Base year: 2025
• Estimated year: 2026
• Forecast year: 2031

Aspects covered in this report
• Long-term care Market with its value and forecast along with its segments
• Various drivers and challenges
• On-going trends and developments
• Top profiled companies
• Strategic recommendation

By Service Type
• Home Healthcare
• Nursing Care / Skilled Nursing Facilities: 
• Assisted Living Facilities
• Hospice & Palliative Care:
• Other Services

By Payer Type
• Public
• Private
• Out-of-Pocket

By Gender
• Male
• Female