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Government Shift to Care at Home

May 10, 2012 by Honey Leave a Comment

In “A Shift From Nursing Homes To Managed Care at Home”   (New York Times, February 24, 2012) Joseph Berger notes that shrinking Medicaid and Medicare funds are forcing closure of more and more nursing homes – 350 nursing home have closed over the past six years nationally.  For example, New York State plans to transfer 70,000 to 80,000 people needing over 120 days of Medicare-covered long-term care (LTC) to their homes.  Studies suggest that care at home can cost less than in a nursing home, so such a policy may stretch scarce Medicaid funds a little further.

Shifting Medicaid funding from nursing homes to in-home care sounds great. Caregivers really like this idea. The whole notion of avoiding nursing home stays is very appealing.

Many policymakers cling to the notion that such a shift will save money, but this is far from the truth.

I quote the following from Steve Moses of the Center for Long-Term Care Reform:

When compared to an elderly population for whom traditionally available care is offered, recipients of expanded community-based services do not use significantly fewer days of nursing home care.[1]

 An increasingly large number of studies, including the results of a national channeling demonstration program, have shown that non-institutional services typically do not substitute for nursing home care, but, rather, represent additional services most often to new populations.[2] 

Although community-based LTC programs proved beneficial to both clients and informal caregivers in the LTC demonstrations, they did not prove budget neutral or cost effective.[3]

For Medicaid to afford quality home health care for all recipients it must have fewer recipients. By tightening eligibility, closing eligibility loopholes, preventing Medicaid planning, and enforcing estate recovery, the program can do a better job for fewer genuinely needy eligibles. When middle class and affluent people understand their savings and home equity are at risk for LTC, they will avoid Medicaid dependency by paying privately from savings, home equity conversion and private insurance.

Here are the footnotes:

[1] General Accounting Office, “The Elderly Should Benefit From Expanded Home Health Care But Increasing Those Services Will Not Insure Cost Reductions” (Dec. 7, 1982) p. 43, http://archive.gao.gov/f0102/120074.pdf.
[2] John F. Holahan and Joel W. Cohen, Medicaid: The Trade-off between Cost Containment and Access to Care, (Washington DC: The Urban Institute Press, 1986), p. 106.
[3] Kenneth G. Manton, “The Dynamics of Population Aging: Demography and Policy Analysis,” The Milbank Quarterly, vol. 69, no. 2, 1991, p. 322.

Filed Under: I'll Just Self-Insure, Information About LTC, Long-Term Care Awareness Month Tagged With: caregivers, Center for Long-Term Care Reform, home health care, Joseph Berger, Medicaid, Medicaid eligibility, New York Times, Steve Moses

Alzheimer’s Disease – A Rapidly Approaching Medical and Financial Crisis

March 28, 2012 by Honey Leave a Comment

The odds that you’ll have Alzheimer’s disease are 1 in 8, according to the “2012 Alzheimer’s Disease Facts and Figures” (Alzheimer’s Association:225 N. Michigan Ave., Fl. 17 Chicago, IL 60601-7633).  An estimated 5.4 million Americans currently have Alzheimer’s, 5.2 million of whom are over 65.  And your odds increase to 1 in 2 if you live to age 85.  As the sixth leading cause of death in theUnited States, this tragic disease currently costs over $200 Billion to treat, and that annual cost is expected to rise to $1.1 TRILLION by 2050!

Where will all that money come from?  Medicare and Medicaid pay for 70% of the current annual cost, and over 15 million Americans provide unpaid care for a person with Alzheimer’s or other dementias.  With each passing year, government funds will become increasingly insufficient to cover this staggering expense, leaving the burden of care on family and friends.  And tragically, even today 800,000 people with Alzheimer’s live alone and as many as half of them have NO caregiver.  We can only imagine how that number will soar with each passing year.

So what’s the answer?  The good news is that “cognitive impairment” is a valid basis for a claim on all long-term care insurance (LTCi) policies.  So if this tragedy strikes you and you have purchased such a policy, your LTCi will take the burden off of the US government as well as your family and friends.  The choice is yours…

Filed Under: Helpful Information About LTC, I'll Just Self-Insure, Information About LTC, Long-Term Care Awareness Month Tagged With: Alzheimer's Association, Alzheimers Disease, Long Term Care insurance, LTC Insurance, LTCi, Medicaid, Medicare

A Sad, and All Too Common Story

December 18, 2010 by Honey Leave a Comment

I recently made a long-term care (LTC) insurance presentation to a 62 year old woman, still working full-time.  She was very eager to meet with me and learn about how LTC works and how much it costs.  Before my visit, she explained that she smokes and is so small she’s almost below desirable height and weight guidelines, because she is a caregiver. She went on at length, emptying her heart to me before we even met. I think she knew I understood what she was going through. I think she is in a state where she is continuously overwhelmed by her circumstances, to the point where they pre-occupy her subconsciously. I’m sure she is effective at work, but I feel her load is so heavy and overwhelming that it must cast a gray cloud over everything she does.

She described her constant state of concern about her husband, because he suffers from Alzheimer’s Disease.  Evidently, he is still able to stay at home, unsupervised, during the day, while she works. I believe she realizes this may not be the optimal alternative for him, and that he may fall into harm’s way. When she returns home at night, and during weekends, her life is consumed by her caregiving responsibilities. To hear her tell it, she has no social life whatsoever. She is extremely aware of the fact that although her husband is presently able to remain home during the day unsupervised, she knows its only a matter of time before this will no longer be possible. She also expressed fear of when that day might come. Hers is a one day at a time existence. She cannot make any plans. Indeed, she commented that all the plans they had made, have changed. I think she’s like a bird in a cage. I have tremendous empathy for her.

Who would understand better than this woman, the urgent need for her to buy LTC insurance?

During my presentation, we talked about the fact that if LTC had been in place for her husband, their economic and social situation would be entirely different. For example, there would be a caregiver at home, to offer her respite. She would not be worrying about how to pay for care. She would not be carrying the same large burden, and nagging fear of the worst. We talked about LTC being necessary so that her son would not be caught in the same dilemma if she winds up needing any type of care. We talked about the dignity of having choices, and not having to depend entirely on loved ones, that LTC insurance can provide.

I am blogging about this because of the disturbing outcome of this story. Unfortunately, I have encountered similar circumstances and outcomes over and over, in my 19 years as a long-term care insurance specialist. Perhaps no one understands the importance of LTC insurance better than this lady.  Often, people in these situations get paralyzed, like a deer caught in headlights. They are unable to see the forest for the trees. They are panicked. They are frozen. They are unable to come to decisions. They feel they cannot afford to spend any money. I showed this lady some very low LTC premiums, but she was unable to go forward with an application.

This makes me so sad.

Filed Under: Denial, Helpful Information About LTC, Information About LTC, Long-Term Care Awareness Month Tagged With: Alzheimers Disease, dementia, Long Term Care insurance, LTC, LTC costs

Long-Term Care Awareness Month Re-cap

November 28, 2010 by Honey Leave a Comment

AALTCI LogoWe had a wonderful 2010 Long-Term Care Awareness Month (LTCAM) here in Houston.

The goal of LTCAM is to make the public more aware of the need for responsible long-term care (LTC) planning. It is nationally sponsored by the American Association for Long-Term Care Insurance.

I want to thank The Forum at Memorial Woods and my contact at The Forum, Keri Shaw, in particular, for organizing and generously underwriting the 2010 LTCAM luncheon there on November 4, 2010. The luncheon was filled to capacity. I was told that people were turned away. Houston City Council Member Melissa Noriega and her assistant, Toya Ramirez, came from City Hall to present Mayor Parker’s proclamation that November 2010 is LTCAM in Houston. I gave a talk at the luncheon called “LTC Current Events.”

On November 16, 2010, a group of 10 of us, representing Houston LTCAM sponsors The Forum at Memorial Woods, Senior Resource Guide, The Houston Area Continuity of Care, and the Houston Association of Health Underwriters, went before Houston City Council to publicly accept the 2010 LTCAM proclamation from Mayor Annise Parker.

It’s been an exciting month!

Filed Under: Long-Term Care Awareness Month Tagged With: AALTCI.org, Houston Area Continuity of Care, Houston Area Health Underwriters, Mayor Annise Parker, Senior Resource Guide, the American Association for Long-Term Care Insurance

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Honey Leveen, LUTCF, CLTC, LTCP
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Phone: 713-988-4671
Fax: 281-829-7177

Email: honey@honeyleveen.com

Email: honey@honeyleveen.com

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