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New Studies Measure State Long-Term Care Vulnerability

December 23, 2013 by Honey Leveen Leave a Comment

Could it be that after decades of steadfast battle to be heard, Steve Moses, President of the Center for Long-Term Care Reform, is finally being listened to and sought after? Glory be!

I guess the timing is finally right. Governments on state and national levels realize how rapidly time is running out before the predominantly government-paid system of long-term care (LTC) we’ve complacently become accustomed to, implodes.

The Center for Long-Term Care Reform, which Steve runs, has been recently commissioned by GA, VA and NJ to study and produce indexes that measure long-term care vulnerability. If people will stop, look, and digest the results, they are terrifying.

The great thing about the recently published GA and VA studies and the indexes of long-term care vulnerability they produced, is that legislators and policymakers (and anyone else interested) now have analytical tools that will help assess and quantify the future sustainability of their state’s long-term care service delivery and financing system.

Here’s a link to the GA Study: http://www.georgiapolicy.org/ftp_files/IndexofLong-TermCareVulnerability.pdf. The index of long-term care vulnerability is found on pages 27-28.

More information about the studies and about the Center for Long-Term Care Reform may be found at: www.centerltc.com.

Healthcare.Gov (ACA) and Long-Term Care

October 23, 2013 by Honey Leveen Leave a Comment

Thanks to my colleague, Romeo Raabe, for permission to re-publish his blog, “Heathcare.gov (ACA) and Long-Term Care”.

No, long term care is not directly affected by the Affordable Care Act (ACA, AKA Obamacare) but there are some scary correlations between the two. I refer to this morning’s Wall Street Journal article about what is coming – in both healthcare and long term care.

Doctors are retiring in droves. Those near are taking early retirement to avoid the losses of treating people for less than they are reimbursed. Medicare payments are being cut way back just as 10,000 Americans a day are coming on board (and will each day for the next 18-19 years). The ACA takes large sums from Medicare to fund the ACA. Doctors are reimbursed less and less, as more people are starting to use Medicare, hoping to get doctor appointments scheduled. Doctors often discourage their children from entering the profession. Others won’t accept new patients over the age of 50 (who will get Medicare in 15 years).

Medicaid, the primary payer of long term care in America, is being stretched to millions of uninsured Americans for medical care now. This leaves less for the already under-reimbursed long term care facilities. Nursing facilities tell me they lose between $2000 and $3400 per month on every resident on Medicaid. They cannot make you leave if you run out of funds and turn to Medicaid, but they can – and do – say no to your entrance. If you lose money on every customer, you cannot make it up on volume! They do it gently, asking about what care you will need, and then apologizing that they do not have the staff, currently, to deal with those needs. If the “desirable” LTC facilities turn you away, what choice does this leave you? The less desirable facilities, or one far away that will accept you? I wonder if the people who “wisely” divested their homes and fortunes years ago realized the box they have put themselves in.

More doctors are going into “concierge” medicine, accepting only those patients willing to pay an annual retainer of $500-$3000 a year for ready access and longer consultations. Some LTC facilities also are turning away all Medicaid entrants. The ambience will be nicer, with more staff and better activities and food, and all will pay their fair share with no cost shifting. That is where I want to go when needed, and I have the income from my LTC insurance policy to pay for it. Wouldn’t you like to be in a position to choose such care as well?

With the ACA starting enrollments just as the Medicare Advantage season starts, there is confusion with some going to the wrong site for information and to sign up. Many Americans already believe that LTC is free from the government, and do not realize that Medicaid is not given because you are old, or disabled, it is given because you are impoverished – a fancy word for broke. Why would someone plan to end up that way and dependent on a government that you may have heard rumors of being short on funds itself? LTC insurance is often less expensive than people imagine, and most do not need as much as they initially suspect. Wouldn’t it be prudent to at least investigate?

The 70 – 70 – 70 Problem

April 8, 2013 by Honey Leave a Comment

In a ground-breaking article in the Money Section of US News & World Report (Should Long-term Care Be an Entitlement?) March 25, 2013, Philip Moeller makes the familiar point that the older population that will need long-term care (LTC) is growing and that family members who have historically provided care are fewer in number and scattered all over the globe.

Visitors to this blog are familiar with the attempt to establish a national LTC insurance program (CLASS Act), which was abandoned because of the huge costs required to provide care for all seniors in need. The annual cost of LTC is currently estimated at $725 billion, $450 billion of which is in the form of unpaid care by loved ones. And 200 billion of the remaining 275 billion real dollars come from Medicaid, an entitlement rapidly approaching bankruptcy. Direct personal spending makes up almost all of the remaining $70+ billion, and a mere $7 billion comes from LTC insurance policies.

Bruce Chernof, one of the 15 members of the newly formed national committee to study the LTC crisis, cites a common shorthand for public thinking about long-term care, which he calls the “70-70-70” problem:

70 percent of the people over age 65 will need some of long-term care during their remaining lives.

70 percent of the public does not believe they will ever need such care.

70 percent of the public thinks that if they did need such care, it is already covered by their Medicare insurance. Medicare covers only acute short-term care needs, not long-term care.

This catchy slogan captures the “DENIAL” problem that I have written about extensively in this blog, and Mr. Chernof agrees with all LTC insurance professionals regarding the desperate need for educating the public on these statistics and the importance of reasonably priced LTC insurance. Each of us can educate the public every time we speak to a local group or association, write a blog or article, or make a one-to-one presentation to a prospective client.

Fiscal Cliff Legislation to Create New Long-Term Care Commission

March 23, 2013 by Honey Leave a Comment

On January 1, 2013, the fiscal cliff has was averted at the last minute with the passage of H R 8, the American Taxpayer Relief Act of 2012 (ATRA).

A section of ATRA 2012 includes the formal repeal of the Community Living Assistance Services and Supports (CLASS) Act. The CLASS Act was supposed to create a voluntary, worker-paid long-term care (LTC) benefits program. Health and Human Services Secretary Kathleen Sebelius announced that she could not set up the CLASS Act program because she could see no way to guarantee that the program would be actuarially sustainable. In reality, the CLASS Act has been “deader than a doornail” for a long time. This legislation just makes its demise official.

The most interesting part of ATRA 2012 for me is that it will establish a commission on long-term care.

The LTC commission is supposed to include representatives from LTC insurance providers as well members representing the interests of family caregivers, health care workers, users of LTC services, and users of LTC insurance. Some commission members are supposed to have demonstrated experience in dealing with public and private insurance.

The commission is also supposed to develop recommendations for creating “a comprehensive, coordinated, and high-quality” LTC system within six months after the commission members have been appointed.

We will see how this shakes out. Both parties agree that the biggest causes of budgetary concern are Medicare and Medicaid usage. I want to be optimistic and believe that sane, sustainable solutions for our nation’s long-term care crisis will result. Unfortunately, however, I am skeptical that much good will come of this new, well-intentioned panel, due to the current contentious political climate and the often demonstrated reluctance of legislators to broach the sensitive subject of Medicare and Medicaid reform. Stay tuned…

Older is Not Better…It’s Brutal

February 4, 2013 by Honey Leave a Comment

In “In Hard Economy for All Ages, Older Isn’t Better… It’s Brutal” from the New York Times, February 3, 2013, Catherine Rampell outlines a perfect storm of financial shocks that has eroded the financial security of Baby Boomers – those nearing retirement but not yet covered by Social Security and Medicare.

A summary of the article explaining the oncoming financial/health/lifespan catastrophe, appears below. There are two big crimes I believe Boomers are guilty of. One is avoidance of saving, replaced by living beyond their means. The second is being champions at denial.

The combination of high unemployment, depressed housing values, and low interest rates has reduced older Boomers’ household incomes by 10% since the recovery began three years ago. Many of those who lost their jobs during the Great Recession are too old to be seriously considered for another and too young to collect Social Security or begin living off their retirement savings, which in many cases are paltry. In addition, the unemployed lost the crucial benefit of health insurance and consequently cannot afford routine checkups and preventive maintenance. New research suggests that they may not live as long as expected because of untreated medical problems and financial stress.

What a depressing state of affairs!! But, as the infomercials exclaim, “there’s more!” Nearly 70% of this age group will eventually need some form of long-term care. And even more disturbing is that only 10% of Americans have planned for this potentially staggering additional financial burden by purchasing reasonably priced long-term care insurance (LTCi). The remaining 90% are in denial and counting on blind luck that they will be one of the fortunate 30% who need no extra care in their final years.

My advice to these financially stressed Boomers, AND their younger counterparts who have more time to plan responsibly – explore LTCi as soon as possible! Yes, it will cost you some of your scarce dollars, but take a close look at what you are spending your money on now. Do you really need cable TV? What about eating at home more often or drinking home brewed coffee? Is that expensive vacation trip worth more than the financial assistance that LTCi can provide if you need long-term care?

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New Studies Measure State Long-Term Care Vulnerability

Healthcare.Gov (ACA) and Long-Term Care

The 70 – 70 – 70 Problem

Fiscal Cliff Legislation to Create New Long-Term Care Commission

Older is Not Better…It’s Brutal

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