publication

Long-Term Care Financing

Creating affordable, meaningful care choices for older adults and families


In this open letter, Dr. Chernof commends Governor-elect Gavin Newsom on his commitment to develop "a master plan for aging with dignity" in California. Dr. Chernof lists key areas that a master plan must address, such as incorporating strategies for older adults to live and age in the place they call home and providing pathways for older Californians to access affordable health care.
In this Perspectives, Dr. Chernof discusses our eighth annual California Summit on Long-Term Services and Supports (LTSS), which focused on strategies to strengthen advocacy and raise our collective voices. He also reflects on the two
Immediately following the 2016 presidential election, Dr. Chernof wrote a letter to then President-elect Trump describing five action items for supporting older Americans.
Since inception six years ago, enrollment for The SCAN Foundation’s California Summit on Long-Term Services and Supports (LTSS) has doubled. The LTSS Summit provides a rare opportunity for service providers, aging and disability advocates, health
In this Perspectives, Dr. Chernof highlights the similarities across each set of recommendations and advocates for the multi-pronged approach put forth by all groups—one that clarifies personal responsibility, outlines private market solutions, addresses long-term needs, and refocuses Medicaid’s role.
Last year, modeling efforts distilled various options to improve America’s financing system for long-term care. This month, three organizations – the Bipartisan Policy Center, LeadingAge, and the Long-Term Care Financing Collaborative – released related policy recommendations. This analysis identifies common themes and notes where the recommendations differ in perspective.
This policy brief summarizes findings from long-term care financing option research by the Urban Institute and Milliman, Inc., courtesy of Health Affairs.
Greater costs for older women, who average 2-1/2 years of high-level need.
Half of U.S. reaching 65 will need high levels of costly help with daily activities.
1 in 7 of all older Americans will need a high level of help with everyday activities for 5+ years.
Families pay >50% of costs for high-level needs that older Americans face.
Our annual summits create space for thought-leaders to learn and dialogue with each other about critical windows of opportunity, and how best to transform California's long-term services and supports ystem. Read Dr. Chernof's Perspectives on some key areas for system transformation that were discussed at the 2015 LTSS Summit.
Read Dr. Bruce Chernof's Perspectives exploring progress on eight areas from the Affordable Care Act to help older Americans get the right care at the right time by the right providers.
$97,820 - Cost of nursing home care is two and a half times what a family makes a year. $42,406 - Family income level. $35,802 - Cost of home care is almost all of a family’s income. 5% of Californians over 40 have long-term care insurance coverage.
70% of Americans who reach age 65 will need some form of long-term care for an average of three years.
It is no secret that Americans are aging, but what is too often lost in this fact is that most people will need help as they grow older. Unfortunately, America does not have a strategy to deal with this growing demand. For some, this help comes in the form of needing just a little bit of assistance in the home with cooking meals or getting groceries. For others, it is more comprehensive daily help in assisted living or nursing home care.
This brief seeks to answer the question of how many employed individuals (who work for large companies, small companies, or are self-employed) do not currently have access to long-term care coverage. This brief also considers the characteristics that make different types of employers strong or weak prospects for long-term care planning options.
This brief series summarizes current issues in financing long-term care and outlines policy options for increasing affordable access to services.
This brief series summarizes current issues in financing long-term care and outlines policy options for increasing affordable access to services.
Many older adults pay for long-term care out of their income and personal savings until they are poor enough to qualify for Medicaid. In an effort to avoid exhausting their resources and relying on Medicaid, others depend on unpaid family support or go without needed services. Learn more in this policy brief, developed with Avalere.
This paper serves as an overview of the Shaping Affordable Pathways for Aging with Dignity series. The series summarizes current issues in financing long-term care and outlines policy options for increasing affordable access to services.
Medicaid provides an important safety net for people who are poor or become poor, either because of the high costs of health and long-term services and supports, or for other reasons. The transition from non-Medicaid to Medicaid status can be difficult, especially since it is often associated with illness, disability, and declining income and assets.
For people who have been independent all of their lives, transitioning to Medicaid means depending on a means-tested welfare program for their health and long-term care services. Moreover, people transitioning to Medicaid are a substantial portion of state Medicaid expenditures. In an effort to avoid exhausting their resources and relying on Medicaid, others depend on unpaid family support or go without needed services.
The long-term care financing series summarizes current issues in financing long-term care and outlines policy options for increasing affordable access to services.
High quality, cost effective health care delivery is all about targeting – the right care, by the right provider, at the right time, in the right place, and for the right cost. It sounds straightforward, almost easy. The challenge to getting it right is understanding the range of variables in a person’s life that drive health care use and costs. Find out more in this week's Perspectives.
In this Perspectives, Dr. Chernof discusses several ways that health reform provisions can support effective transitions.
This policy brief examines the “service fulfillment” challenges posed by the CLASS Plan. New and improved mechanisms will be needed for connecting consumers of in-home services and supports with the workers who provide them.
In this policy brief, demographics and key attitudes that differentiate long-term care insurance buyers from those who do not buy are reviewed. This analysis can help the CLASS Plan inform a more cost-effective targeted marketing strategy, reaching out first to those most receptive to the product.
This policy brief looks at best practices in gaining strong participation rates in employer-sponsored, long-term care insurance offerings to help inform strategies for the success of the CLASS Plan.
This policy brief describes lessons learned from the Own Your Future consumer awareness campaign in regard to the best means and messages to encourage long-term care planning and how this information may be useful for communications outreach for the CLASS Plan.
This policy brief describes the benefits and challenges of using debit cards and cash in CLASS and how they could be implemented and integrated into a Financial Management Services structure.
This policy brief describes the use of cash, debit cards, and third-party payers in various participant-directed programs and suggests how these findings can inform the design and implementation of the CLASS Plan.
This policy brief seeks to inform the design and implementation of the CLASS Plan using experience from the provision of Financial Management Services (FMS) in participant direction. We seek to present strategies for maximizing FMS benefits in the CLASS Plan.
This policy brief describes the history and operation of debit cards and provides examples of their use in government programs to inform the use of debit cards to access CLASS Plan benefits.
This policy brief addresses some similarities between the Cash and Counseling (C&C) model and CLASS, including participant control over a cash benefit, the ability to develop an individualized spending plan, the ability to hire family members as workers, and the availability of a range of programmatic supports to help participants manage their responsibilities.
This policy brief focuses on components of states’ Medicaid functional assessment processes with an eye toward how these processes could potentially inform the development of regulations for CLASS. We explore how states handle the assessment process and determine who performs the assessment and where it is performed.
This policy brief focuses on the ranking and scoring criteria and mechanisms that state Medicaid programs use to determine functional need and the level of services provided for Medicaid-funded personal care services programs. This information can be very useful for the development of the CLASS Plan.