LTC Bullet:  Long-Term Care News and Analysis

Friday, September 1, 2017

Seattle—

LTC Comment:  Center for Long-Term Care Reform Premium members have the option to receive our LTC Clipping Service and weekly LTC E-Alerts newsletters.  Today, we’d like to share a sample of these members-only services with a wider audience.  Our topic is the news this week, so we’ll skip our usual ***news*** section and dive straight in.


LTC Bullet:  Long-Term Care News and Analysis

Many Center for Long-Term Care Reform Premium members are familiar with our LTC Clipping Service, and from what we hear, get great value from this benefit of Premium membership.

For those who don’t already know, our LTC Clipping Service is an excellent way to stay on top of current and critical long-term care news without having to spend hours a day researching on the internet.  We send our Clipping Service subscribers an average of 2-3 emails per workday with a must-read-article link, a pull quote and some brief analysis.  We’re sensitive to the fact that we all receive too many emails, so we’re very careful to send along only the most important LTC news items. 

As an added benefit and for convenient reference, we keep a running archive of the clippings we send in our new LTC Clippings Archive, dating back to January 2016.  This archive is organized by LTC-related subject and sub-category.  While CLTCR Premium members will continue to receive their LTC Clippings in real time, they and Individual members, have access to the Clippings Archive through our Members-Only Zone website.  Here’s a breakdown of the Archive’s subject categories: 

  • INSURANCE (Long-Term Care Insurance, Critical Illness Insurance, Hybrid and Miscellaneous [including alternative financing solutions])
  • LONG-TERM CARE (General, Cost, Assisted Living, Nursing Homes, Home Care, Caregiving, Veterans Affairs and Government Solutions)
  • MEDICAID (General and Medicaid Planning and Crowd-Out Effect)
  • MEDICARE (and Medi-Gap and Medicare Advantage)
  • SOCIAL SECURITY
  • ALZHEIMER'S DISEASE
  • POLITICS, LEGISLATION AND PUBLIC POLICY
  • ECONOMICS, DEMOGRAPHICS AND DATA
  • RETIREMENT PLANNING
  • HEALTH AND HEALTHCARE
  • OTHER

If you’re reading this, chances are you play a valuable role in protecting people from the risk and cost of long-term care and to that end we think the Clipping Service allows our subscribers to be more effective doing so.  Based on their feedback, we think our subscribers feel the same.  For example:

I find your clipping service invaluable. It helps me stay current not only with industry news (carrier’s, legislation and such) but consumer news as well. Every agent should be reading these stories daily… their clients and prospective clients are. To offer the best service one must be informed. Thank you for all your hard work in providing this service and thank you for being such a strong and dedicated advocate for our industry. -- Phillip W. Sullivan, President – SellingLTC.com

Your clipping service has saved me hundreds of hours of research each year since we started receiving your clippings.  Using it makes me feel confident knowing that I’m on top of anything happening in the industry – from legislation to state movements to industry and insurer announcements.  And being on top of things is critical in our industry.  Any serious LTCi agent who doesn’t take advantage of this . . . doesn’t realize the value the service can bring to their production!  For anyone above the level of agent, this service has to be considered a must.  Thank you for your diligence in uncovering all the daily news a person in our industry needs! -- Mark Randall, LTCI Trainer

Please find below a sample collection of clippings we’ve sent to our Clipping Service subscribers over the past two weeks.  Read through them and if you think that receiving news items like these in real time would be valuable to you, please consider subscribing at the Premium membership level.  By doing so, you can stay on the forefront of professional knowledge and help us fight for rational long-term care policy reform.  

Contact Damon at 206-283-7036 / damon@centerltc.com to start your Premium Membership immediately or go directly to our secure online subscription page and sign up for as little as $21 per month.

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8/31/2017, “Long-Term-Care Insurance Gets a Makeover,” by Ellen Stark, Consumer Reports

Quote:  “Once you or a family member starts having trouble with everyday activities, such as preparing meals and showering alone, you might need some assistance. It could be help from a home health aide or a move into an assisted living facility or a nursing home. Planning for this can be a fraught exercise. But there are new types of long-term-care insurance that might help.”

LTC Comment: A positive Consumer Reports article on LTCI? Check to see if the moon is blue tonight. Stephen D. Forman of Center- corporate-member Long Term Care Associates is quoted in the piece.

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8/29/2017, “Home Health Care: Shouldn’t It Be Work Worth Doing?,” by Eduardo Porter, New York Times

Quote:  “How to provide long-term care for a fast-aging population poses one of the more convoluted challenges of the American labor market. Care providers — home health aides, personal care attendants and certified nursing assistants, in the government’s classification — are expected to be among the nation’s fastest-growing occupations. The Department of Labor’s economists expect about a million more will be added from 2014 to 2024. And yet despite their critical importance to the well-being of tens of millions of aging Americans, one-fourth of these aides live in poverty. The jobs are so unappealing that it is hard to keep workers in them: four in 10 leave the occupation entirely within a year. Many prefer the fast-food business.”

LTC Comment: Articles like this exasperate me. We have a problem with home health caregiving because Medicaid made nursing home care free which crowded out private markets for home health and private insurance to pay for it. So how do we fix it? Spend more Medicaid money to save more Medicare money. Yeah, that’ll happen.

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8/28/2017, “How Senior Living Costs Can Devastate Middle-Class Americans,” by Mary Kate Nelson, Senior Housing News

Quote:  “Boosting affordability is top of mind for many senior housing providers, as it’s becoming increasingly obvious that many baby boomers will struggle to pay for senior living—even those who are comfortably in the middle class. That’s already the stark reality for 60-year-old Kuna, Idaho, resident Betsy Winkler, according to a report in the Miami Herald. Winkler’s husband, 69-year-old David Winkler, has Alzheimer’s disease. He lives and receives care at Ashley Manor Memory Care community in Boise, Idaho, for which the couple currently pays $48,000 per year.”

LTC Comment: The bigger story is that this is the exception, not the rule. Long-term private pay in a nursing home is almost non-existent having collapsed from 50% a few decades ago. Who pays? Medicaid. No wonder so few people worry about LTC risk and cost enough to save, invest or insure.

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08/27/2017, “Complete Your Pre-Retirement Checklist,” by Wendy Connick, The Motley Fool

Quote: “Before you finally and officially retire, it's important to make sure you're ready for such a huge shift in your lifestyle and your finances. Much like a pilot will complete the tasks on a pre-flight checklist before the plane ever leaves the ground, you should read through and complete the tasks on your retirement checklist before deciding to leave the workforce forever.

“Look into long-term care insurance (10-15 years before retirement)
If you're going to buy long-term care insurance, the best time to do so is in your 50s, not your 60s. Your premiums will be much lower if you buy the policy this early. Plus, by getting that decision out of the way so far in advance, you'll simplify the often chaotic pre-retirement years by resolving one of your critical decisions. Because the majority of retirees will need long-term care at some point, and the costs can easily run into the six-figure range, long-term care insurance is likely a good financial move. At least look at a few policies and consider how they'd fit into your retirement budget. If you decide to pass on long-term care insurance, you'll definitely need to come up with some other way to pay for long-term care.”

LTC Comment: LTCI is at the top of this pre-retirement checklist.

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08/28/2017, “Long-term care insurance becomes more expensive, even as the cost of aging skyrockets,” by Mary Katherine Wildeman, Post and Courier

Quote: “Barbara Franklin has slowly watched over the years as companies offering long-term care insurance have dropped out and premiums have become difficult to afford. As a long-term care specialist and the owner of Franklin & Associates, she said she guides her clients through the decisions they're faced with as they approach retirement. Often the choices are impossible. While long-term insurance costs rise, so, too, do the debilitating costs of long-term care. An annual cost estimate from Fidelity Investments found last week that a 65-year-old couple will need $275,000 to pay for health care during their retirement, a 6 percent increase over last year. Franklin said having her own responsibilities to care for her 92-year-old mother have reminded her to focus on the importance of making sure her clients can pay for the long-term care they will likely need one day.” 

LTC Comment: This article features CLTCR friend and member, Barbara Franklin, and ultimately focuses on the value of LTCI policies in spite of rate increases.

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08/28/2017, “This Is How Much Your Kids Are Worth,” by Suzanne Woolley, Bloomberg

Quote:  “Michael Hurd doesn’t have a long-term-care insurance policy, but he does have something likely to prove valuable in his old age, however—two daughters. Few Americans assign a dollar amount to the worth of their children—they are without price. But as lead author of a new study looking at nursing home cost and use, Hurd can quantify the value that daughters, and children in general, bring to parents facing one of life’s most dreaded prospects: a stay in a nursing home.” 

LTC Comment: If it’s beneficial to consider how much a person’s children are worth in terms of LTC services they might provide, it should also be beneficial to consider how much it’s worth to spare those children the known health consequences of providing that care. Unfortunately, this article does not do so and undermines the importance of real long-term care planning.

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08/28/2017, “Is Your Retirement Plan as Well Thought Out as Your Vacation?,” by Mark Pruitt, Kiplinger

Quote: “After working hard all of our lives, the goal for most of us is to have the freedom to go explore and complete the ‘bucket list’ that we have always dreamed of. The problem is most people plan their vacations better than they plan their retirements.

“6. Devise a long-term care plan.

Six members of my wife’s family have had Alzheimer’s disease. My mother-in-law had it for 16 years. My sister-in-law has it currently and started her journey with Alzheimer’s at age 55. I have seen it on a very personal level. I have long-term care strategies for my wife and me in multiple forms. My parents have multiple forms of long-term care as well. Know your options. Traditional long-term care costs a premium. Can you afford it? The length of traditional long-term care policies is typically three to five years. What if you keep on living, as my mother-in-law did? The long-term care for my family started in the home and graduated to a nursing home. Layered options could include the use of non-traditional means like annuities with enhanced benefits riders that could be used for in-home, assisted living or nursing home care. Some life insurance policies have additional living benefits to help pay for care. Lack of planning for long-term care could devastate families. At the very least, explore all of your options.”

LTC Comment: A timely take on retirement planning in this vacation season.

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8/23/2017, “Opinion: Why nursing homes are suffering from old age problems,” by Betsy Rust, MarketWatch

Quote:  “Remember nursing homes? Someday, perhaps as soon as the next decade, that’s how Americans may start to think about them — in the past tense, as institutional relics. The grim economic reality is that many nursing homes are facing extinction. In fact, I predict that the confluence of a number of trends — demographics, competition from nursing home alternatives, federal and state health-care policy and even technology — will mean as many as 20% of nursing home beds will be eliminated in the next five years.”

LTC Comment: So true, but why and what should be done about it? That’s why I sent this note to the author:

Dear Ms. Rust,

Based on your MarketWatch op-ed, I think you are very thoughtful and concerned regarding long-term care. I’ve spent 35 years working in and thinking about the challenge of long-term care services and financing. So I share your concern.

You’re right that nursing homes are hurting, unresponsive to the demographic onslaught, and challenged by less institutional options. But do you know how we came to have a nursing-home-based, welfare-financed long-term care system in the first place? More importantly, what has to change to improve long-term care?

I’d like to share my latest paper with you:  How to Fix Long-Term Care Financing (2017). Honestly, I think it will open your eyes to some fascinating insights and even, possibly, to some business ideas.

Sincerely,

Steve Moses

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8/18/2017, “LTC deals led healthcare transactions for July,” by Emily Mongan, McKnight's LTC News

Quote:  “Long-term care facilities dominated healthcare transactions compared to other sectors in terms of deal volume in July, according to a new update. . . . The trend is showing no signs of slowing down, Gary Herschman, an attorney with the firm Epstein Becker & Green, told Bloomberg. ‘As the baby boomers move into their 60s and 70s, investment continues in the long-term care sector, which expects a corresponding growth in demand for services in the near future,’ Herschman said.”

LTC Comment: Too bad ways to pay for long-term care are not expanding at a pace to keep up with places to receive care.

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4/9/2017, “Why Parents Need to Be Willing to Cut Off Adult Children Financially,” by Maddy Dychtwald, Wall Street Journal

Quote:  “Among those Americans who give their adult children post-college financial support, the average amount given is $6,800 annually, according to the study, a four-year, 50,000-respondent investigation into the changing lifescape of retirement conducted by my firm, Age Wave, in partnership with Merrill Lynch.  And parents are gifting that money just as they are facing their own retirement head on. . . . Supplementing our young adult children might seem like a huge help to them now. But in the long run, perhaps the greatest financial gift we can give them is to be able to afford our own retirement and the possible need for care in retirements that can last 30 years or more. The last thing many of us want is to have to turn to our children for financial help in their 40s or 50s–when they will be focused on paying mortgages, saving for their children’s college fund and funding their own retirements.”

LTC Comment: That $6,800 would buy a very good LTCI policy.

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8/21/2017, “VA seeks to funnel more nursing home money to rural areas,” by Matt Volz, Associated Press

Quote:  “Veterans Affairs Secretary David Shulkin said Monday during a visit to Montana that his agency will propose changes to make it easier for rural areas to receive funding to build nursing homes for veterans. . . . The VA now sets its priority list by looking at veteran demographics and the need for beds, making it difficult for some rural areas to compete, VA officials said. The agency plans to propose regulation changes by year's end to ensure some of the money goes specifically to rural areas. Whatever proposal emerges must go through a public comment period, so it's unclear when any changes may take effect.”

LTC Comment:  We’ll add this story to our members-only-website feature Reasons Why Veterans Should Not Depend on VA Benefits for Long-Term Care with the note “especially in rural America.”

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8/20/2017, “The Language of Long-Term Care: Navigating the care maze can be overwhelming; understanding the lingo can help,” by Christine Benz, Morningstar

Quote:  “As I reflect on my parents' final years, a period that included multiple hospital stays, trips to rehab, and the hiring of in-home caregivers, I realize that my siblings and I were often a step behind with our responses. We initially hired in-home caregivers to help for 10 to 20 hours a week when, in hindsight, we should have had them there every day. We made the difficult decision to move my dad to a long-term care facility with memory care only after he had taken a few serious falls at home that caused him a lot of physical discomfort. And so on.”

LTC Comment: This author and her family could have had crucial care management help if they’d had LTCI. So much of what she says in the article about LTCI and Medicaid is wrong. We’ll reach out to her, explain some things and send her How to Fix Long-Term Care Financing (2017).

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8/17/2017, “The role of advisors in longevity planning,” by Kimberly Foss, Financial Planning

Quote:  “Similarly, boomers don’t really want stocks, bonds, mutual funds or insurance; they want the means to live their desired lifestyle when they are no longer actively employed. They want to solve the problems that come with longevity, and those problems, more and more, go beyond simply funding their retirement accounts. . . . In order to position themselves to adequately respond to the longevity needs of an aging clientele, advisors will increasingly be called upon to provide not just transaction-based assistance, but also to serve as facilitators of the relationships required to address these and other problems. We will fall short helping our aging clients if we stay in our financial silos; instead, we will need to become conduits for leading them to the solutions they require.”

LTC Comment: Hopefully financial advisors will direct clients to LTCI producers rather than Medicaid planners when it comes to long-term care planning, but that has not always been the case.

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8/15/2017, “Could This Idea Help Fix America's Shortage Of Home Care Workers?,” by Chris Farrell, Forbes

Quote:  “The demographics of a growing demand for elder care in America is raising alarms. The number of adults 65 and over requiring long-term care could rise by more than 70% over the next quarter century, estimates MIT Sloan School of Management professor Paul Osterman, author of the new book, Who Will Care for Us?: Long-Term Care and the Long-Term Workforce. But the supply of home care workers is likely to fall short of demand. Perhaps a novel program from the AARP Foundation and Capital Impact Partners, a Community Development Financial Institution based in Arlington, Va., will help solve this problem.”

LTC Comment: A far better idea than home care co-ops is to stop trapping so many people on Medicaid which pays for most home care with rates less than the cost of providing the care. With private payers paying market rates, home care jobs would pay better and attract enough qualified caregivers.

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8/15/2017, “ACA Diluted Funds for the Severely Disabled,” by Paul T. Spencer, Wall Street Journal letter to the editor

Quote:  “The ACA has expanded funding for Medicaid services, but it has also to an even greater degree expanded the pool of people eligible to dip their spoon in the pot. It used to be that Medicaid did a fair job of providing for the truly disabled and needy. Now it does a lousy job of serving more people, many of whom are not truly needy and could provide care for themselves. . . . Please join me in supporting the repeal of the ACA and put Medicaid funding back in the pot for the truly needy and disabled in our society.”

LTC Comment: This letter captures the essence of what ObamaCare did to Medicaid. For the wider significance, see our new report How to Fix Long-Term Care Financing (2017). Thanks to Green Bay, Wisconsin Center Regional Rep Romeo Raabe for tipping us to this item. 

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