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Financing Long-Term Services And Supports: Options Reflect Trade-Offs For Older Americans And Federal Spending.
Health Aff (Millwood) 2015; 34(12):2181-91HA

Abstract

About half of older Americans will need a high level of assistance with routine activities for a prolonged period of time. This help is commonly referred to as long-term services and supports (LTSS). Under current policies, these individuals will fund roughly half of their paid care out of pocket. Partly as a result of high costs and uncertainty, relatively few people purchase private long-term care insurance or save sufficiently to fully finance LTSS; many will eventually turn to Medicaid for help. To show how policy changes could expand insurance's role in financing these needs, we modeled several new insurance options. Specifically, we looked at a front-end-only benefit that provides coverage relatively early in the period of disability but caps benefits, a back-end benefit with no lifetime limit, and a combined comprehensive benefit. We modeled mandatory and voluntary versions of each option, and subsidized and unsubsidized versions of each voluntary option. We identified important differences among the alternatives, highlighting relevant trade-offs that policy makers can consider in evaluating proposals. If the primary goal is to significantly increase insurance coverage, the mandatory options would be more successful than the voluntary versions. If the major aim is to reduce Medicaid costs, the comprehensive and back-end mandatory options would be most beneficial.

Authors+Show Affiliations

Melissa M. Favreault (mfavreault@urban.org) is a senior fellow in the Income and Benefits Policy Center at the Urban Institute, in Washington, D.C.Howard Gleckman is a senior fellow in the Urban-Brookings Tax Policy Center at the Urban Institute.Richard W. Johnson is a senior fellow in the Income and Benefits Policy Center and director of the Program on Retirement Policy at the Urban Institute.

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't
Research Support, U.S. Gov't, Non-P.H.S.

Language

eng

PubMed ID

26572919

Citation

Favreault, Melissa M., et al. "Financing Long-Term Services and Supports: Options Reflect Trade-Offs for Older Americans and Federal Spending." Health Affairs (Project Hope), vol. 34, no. 12, 2015, pp. 2181-91.
Favreault MM, Gleckman H, Johnson RW. Financing Long-Term Services And Supports: Options Reflect Trade-Offs For Older Americans And Federal Spending. Health Aff (Millwood). 2015;34(12):2181-91.
Favreault, M. M., Gleckman, H., & Johnson, R. W. (2015). Financing Long-Term Services And Supports: Options Reflect Trade-Offs For Older Americans And Federal Spending. Health Affairs (Project Hope), 34(12), pp. 2181-91. doi:10.1377/hlthaff.2015.1226.
Favreault MM, Gleckman H, Johnson RW. Financing Long-Term Services and Supports: Options Reflect Trade-Offs for Older Americans and Federal Spending. Health Aff (Millwood). 2015;34(12):2181-91. PubMed PMID: 26572919.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Financing Long-Term Services And Supports: Options Reflect Trade-Offs For Older Americans And Federal Spending. AU - Favreault,Melissa M, AU - Gleckman,Howard, AU - Johnson,Richard W, Y1 - 2015/11/16/ PY - 2015/11/18/entrez PY - 2015/11/18/pubmed PY - 2017/1/31/medline KW - Elderly KW - Financing Health Care KW - Long-Term Care SP - 2181 EP - 91 JF - Health affairs (Project Hope) JO - Health Aff (Millwood) VL - 34 IS - 12 N2 - About half of older Americans will need a high level of assistance with routine activities for a prolonged period of time. This help is commonly referred to as long-term services and supports (LTSS). Under current policies, these individuals will fund roughly half of their paid care out of pocket. Partly as a result of high costs and uncertainty, relatively few people purchase private long-term care insurance or save sufficiently to fully finance LTSS; many will eventually turn to Medicaid for help. To show how policy changes could expand insurance's role in financing these needs, we modeled several new insurance options. Specifically, we looked at a front-end-only benefit that provides coverage relatively early in the period of disability but caps benefits, a back-end benefit with no lifetime limit, and a combined comprehensive benefit. We modeled mandatory and voluntary versions of each option, and subsidized and unsubsidized versions of each voluntary option. We identified important differences among the alternatives, highlighting relevant trade-offs that policy makers can consider in evaluating proposals. If the primary goal is to significantly increase insurance coverage, the mandatory options would be more successful than the voluntary versions. If the major aim is to reduce Medicaid costs, the comprehensive and back-end mandatory options would be most beneficial. SN - 1544-5208 UR - https://www.unboundmedicine.com/medline/citation/26572919/Financing_Long_Term_Services_And_Supports:_Options_Reflect_Trade_Offs_For_Older_Americans_And_Federal_Spending_ L2 - http://www.healthaffairs.org/doi/full/10.1377/hlthaff.2015.1226?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -