Research for the Auditor General and the Accounts Commission said current ways of working were unsustainable, with challenges including an ageing population and financial pressures facing councils and health boards.
The number of people aged 85 and over in Scotland is expected to rise by two-thirds from 114,375 in 2014 to 187,219 in 2030, and double by 2034.
New ways of working are emerging in some parts of Scotland but change is not happening fast enough to meet the growing need for services, the report said.
It called on the Scottish Government to provide stronger leadership and a clear plan for implementing its 2020 vision, which aims to have more people cared for at home.
The report also urged ministers to identify “adequate and timely longer-term funding to support transformational change”.
Between 2010/11 and 2014/15 the health budget decreased by 0.6% in real terms to £11.85 billion while Scottish Government overall funding for councils decreased by 5.9% in real terms to £10.8 billion.
Spending on social care services increased slightly by 2% to about £3 billion between 2010/11 and 2013/14.
Auditor General Caroline Gardner said: “An ambitious vision can be a catalyst for change but without a clear and detailed plan of action, there’s a risk that ambition is overtaken by circumstances.
“Current health and social care models are unsustainable but with the right services in place, many people could avoid unnecessary admissions to hospital or be discharged more quickly.
“The Scottish Government must produce comprehensive long-term plans for realising its 2020 Vision and work to reduce the barriers that hold local bodies back from creating new ways of working that meet the changing needs of their communities.”
Dr Alan McDevitt, chair of BMA Scotland’s GP committee, said the report was a “timely warning” of the pressures facing the NHS.
He said: “These huge challenges that the health service is facing means that changes are needed, but those changes must be resourced adequately if they are to succeed.”
Scottish Liberal Democrat health spokesman Jim Hume said: “This report reveals a health and social care system that faces a perfect storm of an ageing population, real-terms spending cuts, huge pressure on primary care services and a lack of leadership from SNP ministers.”
Scottish Conservative health spokesman Jackson Carlaw said: “Time is running out and an impending crisis is fast developing into an actual one. The Scottish Government needs to show that it can lead and produce a solid and comprehensive plan.”
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