The SCAN Foundation and Avalere Present the Long-Term Care Policy Simulator

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The SCAN Foundation, in partnership with Avalere Health, released a web-based modeling tool that enables policymakers and the public to test the budgetary implications of a wide variety of federally run long-term care insurance programs. The model, called the Long-Term Care Policy Simulator, produces more than 2,500 unique outputs, each illustrating how public long-term care insurance program designs and benefits translate into estimated coverage, participation rates, and costs to participants and taxpayers. Read more in this report.

Date Updated: 04/13/2010

Introduction

The recently passed Patient Protection and Affordable Care Act contains a provision that supporters hope will help shift the United States from a Medicaid financed long-term care (LTC) system to a premium funded, public long-term care system. This legislation, the Community Living Assistance Services and Support (CLASS) Act, has attracted support, in part because it addresses two policy concerns. The first is that the need for LTC is an insurable event for which few Americans have coverage. Related to that is the concern that limitations of private LTC insurance prevent it from serving as the source of this coverage for most Americans…


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This policy brief provides background on the historical development of benefit eligibility triggers in the private long-term care insurance market. Understanding how these triggers came into being can provide important information to those charged with implementing the CLASS Plan.

This policy brief provides information about how long-term care insurers implement benefit eligibility triggers in the private insurance market. The way in which companies have operationalized benefit eligibility triggers can inform the development of regulations for the CLASS Plan.

This policy brief provides information on the benefit eligibility assessment process in the private long-term care insurance industry. It focuses on how long-term care insurers use the information in the adjudication process, who is involved in the process, and how activities of daily living and cognition are assessed.