Roybal Center for Health Policy Simulation

Moving health simulation findings into programs, practices, and policies

More than a dozen countries use the Future Elderly Model (FEM) to forecast long-term trends in disease dynamics.
Using the Future Elderly Model (FEM), the Roybal Center conducted analysis to project Medicare demographics and spending for 2030.


For more than a decade, the USC Roybal Center for Health Policy Simulation has been developing health and economic simulation models and collaborating with researchers all over the world to answer salient policy questions in the United States and globally.  Funded by the National Institute on Aging, Center affiliates collaborate to research determinants of health and health spending among older populations and translate these findings for policy makers who influence aging policy.

Read more about the USC Roybal Center’s microsimulation capabilities here.


In a partnership with Nobel Memorial Prize winner Jim Heckman and researchers at the University of Chicago, the Future Americans Model (FAM) was adapted to estimate benefits from an influential early childhood program targeting disadvantaged families in North Carolina, which followed participants through their mid-30s. The adapted FAM forecasted health outcomes for the subjects from this point through their projected age of death.

The results, featured in Washington Post, The New York Times, The Atlantic, Politico, and on NPR, show that the programs were highly beneficial across the lifetime, impacting factors such as health, income, and education for both children and mothers. Compared to preschools serving children starting at three or four years old, programs starting at birth can yield a significantly greater return on investment – 13% per year compared to 7-10% per year.




The Roybal Center used the Future Elderly Model to generate a snapshot of shifting Medicare demographics and spending between 2010 and 2030.

Presented at a forum hosted jointly with the Center for Health Policy at Brookings, findings reveal that baby boomers, who began turning 65 and aging into Medicare in 2011, will drive Medicare demographic changes, swelling the estimated U.S. population aged 65 or older from 39.7 million to 67.0 million. Fueled by demographic and health shifts, the FEM predicts that Medicare spending will more than double to $1.2 trillion by 2030.





In a recent National Academy of Sciences, Engineering, and Medicine report, a committee chaired by Ronald Lee (U.C. Berkeley) and Peter R. Orszag (Citigroup) collaborated with Roybal Center researchers to investigate the macroeconomic implications of trends in health inequality in the US.

Using the Center’s Future Elderly Model (FEM), the committee examined how changes in life expectancy will likely affect the progressivity of federal programs. Findings suggest significant reductions in progressivity of both Medicare and Social Security if current mortality trends persist and noticeable effects on total program costs.