LTC Bullet: Seeking LTC Solutions

Tuesday, July 15, 2003

Anacortes, WA--

LTC Comment: Cynics say "there's no magic bullet." Optimists insist "where there's a will, there's a way." The Center for Long-Term Care Financing seeks grant support for state-level studies to identify the "pressure-point problem" of LTC financing and to rally long-term care stakeholders to fix it. More after the ***news.***

*** Upcoming conferences:

THE 2003 NATIONAL LTCI PRODUCERS SUMMIT, presented by Sales Strategies magazine, has a timely program featuring 25 workshops and 50 leading LTCI experts. This year the Summit will be held November 16-18, 2003 at the Astor Crowne Plaza Hotel in New Orleans. Complete program details have just been posted on the Web at . Early bird registration is $395. Deduct $50 by writing "CLTCF" in the "Code" box on the registration form, acknowledging the Center for Long-Term Care Financing referred you. Last year at this conference in St. Louis, Center President Steve Moses debated Medicaid planning with NAELA President Bill Browning. This year, Steve will moderate a program featuring the "head fed" for Medicaid, Dennis Smith: what does the Center for Medicaid and State Operations plan for LTC and how will government policy impact the LTCI market?

THE SOCIETY OF ACTUARIES' next long-term care insurance conference is coming up February 8-11, 2004 in Houston, Texas at the Hilton Americas. Tag your calendar now and we'll keep you apprised of details as the date approaches. For a comprehensive review of this year's version of the meeting, see our "Virtual Visit to the SOA-LTCI Conference in Las Vegas" in the donor-only zone: . To become a donor and get your user name and password to The Zone, see immediately below or go to . ***

*** LATEST DONOR-ONLY ZONE CONTENT: Here's the latest Zone content followed by instructions on how to subscribe.

The LTC Reader #3-031--The Tangled Web of Medicaid Planning (How a Court of Appeals approved a $300,000 transfer of assets which the state Medicaid agency had denied.)

The LTC Data Update #3-018--State Medicaid Website Addresses (Find your state's Medicaid website and see if you can figure out the eligibility rules for long-term care benefits.)

Don't miss our "virtual visits" to major LTC industry conferences in The Zone. You'll find our comparison of the conferences, session summaries, interviews and pictures at .

Individual donors of $150 or more and corporate donors to the Center for Long-Term Care Financing receive our daily email LTC Bullets, LTC E-Alerts, LTC Readers, and LTC Data Updates for a full year. You'll also get access to the donor-only zone where these publications are archived along with other donor-only features. If you already qualify for The Zone, you can click the following link, enter your user name and password, and go directly to the latest donor zone content and archives: . If you do not already qualify for The Zone, mail your tax-deductible contribution of $150 or more to the Center for Long-Term Care Financing, 2212 Queen Anne Avenue North, #110, Seattle, WA 98109. Then email your preferred user name and password (up to 10 characters each). You can also contribute online by credit card or direct withdrawal at . ***


GRANT REQUEST. The Center for Long-Term Care Financing seeks grants of $10,000 or more to conduct a series of state-level studies as described below. Government, foundation or corporate grantors may select the states in which they would like their studies conducted, subject to approval by and cooperation of state Medicaid officials. Contact Executive Director Amy McDougall to schedule a conference call to discuss your organization's participation: or 425-377-9500 .

OVERVIEW. Experts recognize that long-term care for the elderly is a ticking demographic time-bomb. Yet, most legislators and policy makers focus on retirement security and acute health care policy to the neglect of long-term care. Grantors with vision will look beyond the next bend in public policy and direct support to the 800-pound gorilla of social problems: How can America finance long-term care for the aging baby-boom generation? That is the crucial question that the Center for Long-Term Care Financing is addressing.

THE PROBLEM. In America today, people can ignore the risk of long-term care (a 9% probability of spending 5 years or more in formal long-term care), avoid the premiums for private LTC insurance (often thousands of dollars per year for older people), wait to see if they ever need expensive professional LTC services (roughly half will need some), and if necessary, transfer the cost of care to the government with relative ease (80% of all patient days in nursing homes are paid at least in part by Medicaid, a means-tested public welfare program.) Since 1965, Medicaid and Medicare have desensitized the public to the risk of long-term care by subsidizing relatively easy access to reduced-cost nursing home care. Consequently, we have a nursing-home-based, welfare-financed long-term care delivery system today that is in the latter stages of collapse. Nursing home and home care bankruptcies abound; many assisted living are unprofitable; LTC stock prices are down; debt and equity capital is scarce; government financing is inadequate; staff are in short supply; staff turnover is excessive; care quality is down; lawsuits are up; liability insurance premiums are unaffordable; and, still, very few Americans purchase private insurance to ensure their ability to purchase quality long-term care when needed.

THE SOLUTION. We must somehow rally the public and our state and national leaders around the principle that long-term care is a personal and family responsibility for which people must plan early, and save, invest or insure. We must change public policy to target scarce public resources to the genuinely needy while encouraging everyone who is young, healthy, and affluent enough, to take responsibility for their own future long-term care costs. Unfortunately, entrenched interests profit from and therefore prolong the status quo. Therefore, the first step in the solution is to rally all long-term care stakeholders around a common analysis of the problem and a proposed solution that best furthers their interests.

THE PROJECT. The Center for Long-Term Care Financing conducts statewide policy studies in which we give and take information with everyone involved in long-term care including (1) the governor and staff, (2) key legislators and staff, (3) the insurance commissioner, (4) Medicaid management, line and legal staff, (5) proprietary and non-proprietary nursing home, assisted living and home health providers, (6) senior and consumer advocates, (7) long-term care insurers, (8) Medicaid estate planners, and any other group which the state believes would be appropriate. We analyze the state's long-term care service delivery system; we probe the interviewees' perspectives and interests; and we compile a list of concrete recommendations designed (1) to save the state up to 20 percent of its Medicaid nursing home budget, (2) to advance the interests of all stakeholders by showing them how to work together toward their mutual advantage instead of fighting over scarce public resources, and (3) to enhance access to quality long-term care at the most appropriate level for all citizens--rich, poor and in between.

THE OPPORTUNITY. For the first time since the early 1990s, state tax receipts are plummeting, Medicaid costs are skyrocketing, and legislators and public administrators are worried about budget deficits. In times like these, the politically sensitive issue of long-term care financing cannot be ignored. Ironically, the tragedy of terrorism and the resulting economic downturn have presented a window of opportunity for us to confront the LTC problem. We know of no better way to advance the Center's mission of ensuring quality long-term care for all Americans than to conduct as many of our "Magic Bullet" studies in as many states as possible. Center staff enthusiastically support this project. With grant support from foundations and companies concerned about long-term care financing, we can bring this valuable service to more states that lack the will or financial wherewithal to underwrite them otherwise. Samples of our reports on Illinois, New Jersey, Florida, Maryland, Wisconsin and several other states are available for review. Two of these studies are available on the Center's website at : "The Magic Bullet: How to Pay for Universal Long-Term Care; A Case Study in Illinois," and "The Florida Fulcrum: A Cost-Saving Strategy to Pay for Long-Term Care," .