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Issue: The high cost of long-term care puts financial pressure on families and worsens inequities in many developed countries. But compared with the United States, many other high-income nations have adopted more comprehensive approaches to financing long-term care services. Goal: To understand how different countries and U.S. states finance long-term care. Methods: Analysis of long-term care cost data in the U.S. and spending data from the Organisation for Economic Co-operation and Development for 12 high-income countries. Key Findings and Conclusion: U.S. spending on long-term care is proportionally the lowest among high-income countries, and there is no single approach to funding this care. In many of these countries, and in certain U.S. states, there is broad eligibility for long-term care benefits or substantial financial assistance, paid mostly through the government or social insurance programs. Common approaches to financing include social insurance, universal comprehensive coverage, residual ( or means-tested) systems, and hybrid strategies. Insights from international models and from innovative funding mechanisms being tested by some U.S. states could inform future efforts to reduce the financial burden of long-term care on U.S. families while reducing income- and race-based inequities. [ABSTRACT FROM AUTHOR]