LTC Bullet: Virtual Visit to the 19th Annual ILTCI Conference

Thursday, April 4, 2019

Seattle—

LTC Comment: Whether you were able to attend or not, we hope you’ll enjoy this coverage of LTCI’s premier professional conference, after the ***news.***

*** TODAY'S LTC BULLET is sponsored by Claude Thau, whose revolutionary “Range of Exposure” tool projects clients’ likelihood (joint for a couple) of spending $100,000; $250K; $500K or over $1,000,000 on LTC, based on their personal characteristics, and estimates how much of their cost in each range would be covered by various traditional or linked insurance designs. He also offers other ways to educate and help clients make informed final decisions in 15-20 minutes! Change work-site LTCi from a series of proposal deliveries to an interactive consultation! Claude is the lead author of Milliman’s annual Broker World LTCi Survey & a past Chair of the Center for Long-Term Care Financing. You can reach him at 913-403-5824 or claude.thau@gmail.com. ***

*** CLARIFICATION: LTCI expert Bill Comfort replied to our recent “LTC Bullet: Treasure Trove of LTC Provider and User Data” with a good point. He observed: “It’s also important to note that the ‘Home Health Care’ data is almost exclusively Medicare or Medicaid-funded, short-term, post-acute, home health care delivered in one-hour visits a few days a week. It does NOT include ‘private duty,’ non-medical, ‘home care’ for multi-hour shifts which is effectively private-pay and only loosely regulated when it is by states. The exclusion of private-duty, non-medical, custodial home care also artificially shortens the average lengths reported as well as the number of people needing care. Of course it also excludes all of the private caregiving provided by families/others. Overall this is a very good, rich treasure-trove of data … but it’s not the full picture, and it’s certainly not the full picture of the types of care and services that need to be planned for with LTC insurance.” Points well taken. ***

*** HAPPY BIRTHDAY to your Center for Long-Term Care Reform. The Center turned 21 years old on April 1, 2019. Now it can tip a glass with you to celebrate. Thanks for a great and on-going run! ***

 

LTC BULLET: VIRTUAL VISIT TO THE 19TH ANNUAL ILTCI CONFERENCE

LTC Comment: The 19th Annual Intercompany Long-Term Care Insurance Conference convened at the Sheraton Grand Hotel in Chicago, Illinois from March 24 to 27, 2019. Today’s LTC Bullet offers you a virtual visit to that event, the biggest of its nearly two-decade history.

The meeting’s overall theme was “Imagine the Possibilities.” With nearly 1100 attendees, 52 exhibitors, 36 sponsors (15 Diamond, 4 Platinum, 6 Gold, and 11 Silver), some very interesting food choices, ample adult beverages, and scores of excellent general and breakout sessions, ILTCI was a big success again this year.

Best of all, especially if you couldn’t attend, you can explore the whole program here. Check out the list of sessions. Choose those that interest you. Then click through to the list of presenters and finally to their presentation materials. It’s not the same as being there, but it is the next best thing.

Recognizing high quality professional conferences like this one do not happen without the generosity of numerous sponsors, we encourage you to check them out here.

Opening General Session: Monday, March 25, 2019

Conference Director Peggy Hauser kicked off the proceedings by welcoming the attendees. She thanked and recognized the organizing committee, the speakers and the producers of 165 sessions. She announced the conference charity, the USO, and encouraged everyone to attend a special program by the Alzheimer’s Association. She tickled everyone’s curiosity about the entertainment to be provided by a team of improvisational actors. Finally, Peggy introduced Robert Eaton who will chair next year’s program to be held in Denver, Colorado, March 29 to April 1, 2020. Get it on your calendar!

First order of business was presentation of the “ILTCI Recognition Award” to “a person(s) or organization that has made a significant, long-term contribution towards the attainment of the ILTCI vision” which is “to create an environment for aging in America that includes thoughtful, informed planning that takes into account the most effective and efficient use of resources in addressing the risks and costs of long term care for all levels of American society.” Steve Moses, president of the Center for Long-Term Care Reform, acknowledged the honor saying

I like to think my stuff is kind of edgy, so I was afraid the ‘boos’ might overwhelm the cheers after this announcement, but they didn’t, so thank you. I want to thank the nominators, the board for selecting me, all our wonderful friends and financial supporters. There are too many to list, so I’ll only mention one by name, my son, Damon, whom many of you know. I’ve heard this honor called a “lifetime achievement” award. That sounds like you’re putting me out to pasture. So, to my friends, let me assure you I’m not going anywhere. To those who disagree with me, don’t think this will stop me. Thanks again to all.”

Next, Carroll Golden announced the creation of a new organization she’ll lead intended to keep LTC issues at the forefront and to bring together LTCI producers and general financial advisors more effectively. The new NAIFA Limited & Extended Care Planning Center will offer professional designation programs and other resources for insurance agents and financial advisors, NAIFA said in a center launch announcement. Read more about it here.

Dennis Martin, president of OneAmerica, introduced the conference keynote speaker whom his company sponsored. Jamie Clarke, hockey star and mountain climber extraordinaire, delivered a humorous, self-effacing, and inspirational address urging all to “be of service.”

From the 2018 Stanley Cup Champion Washington Capitals to the heights of the Seven Summits to the peaks of business success, Jamie Clarke draws from his unique position as a winning performance coach and an accomplished adventurer turned acclaimed entrepreneur to help you develop your team, establish your purpose and succeed in any endeavor. One of a handful of people in the world who have climbed the Seven Summits—including two summits of Mt. Everest—Jamie is the creator of the successful outdoor retail company, LiveOutThere.com, which has been named one of Canada’s fastest growing businesses.

Read more about Jamie Clarke here.

Breakout Sessions

We’ll give you brief summaries of the sessions I attended, but my focus was on the “Public Policy & Alternative Solutions” track. So if your main interests lie elsewhere, be sure to look up these other tracks:  

Actuarial & Finance
Claims & Underwriting
Legal, Compliance & Regulatory
Management & Operations
Marketing & Distribution
Producers & Sales

To check those sessions out, go to https://event.crowdcompass.com/iltci19/activities. Once there, click on one of the conference days, March 25 or 26. Scroll through the sessions, which are listed by their track name. Pick a session that interests you. Click on its title. You’ll find a session description and a list of presenters. Scroll down to the bottom of the page and you will find a link to a .pdf with the session’s presentation materials. For example, the first session I attended was this one: 

Mon, March 25th, 10:45 AM - 12:00 PM
Medicare Advantage Expansion into Personal & LTSS
Public Policy & Alternative Financing Solutions Track

Description: Under new federal guidelines, Medical Advantage (MA) plans have more flexibility to expand the benefits and services they offer to include supplemental benefits for members with chronic conditions. This means that the more than 20 million Medicare beneficiaries (representing one-third of the market) potentially have access to an expanded set of LTC services through their MA plan. As of 2019, just under 600 of the more than 2,000 MA plans are offering some type of LTC benefit including personal care services, supportive care, dementia care support, caregiver support programs, and others. This session explores the specifics of what MA plans are providing in LTC, the types of care needs they are serving and what this means for the LTC insurance industry and the consumers we serve.

Session Producer: Eileen Tell, MPH, Independent Consultant, ET Consulting, LLC 

Speakers:
Dr. Larry Atkins, Ph.D., Executive Director, National MLTSS Health Plan Association
Howard Gleckman, Resident Fellow, The Urban Institute
Jay Greenberg, ScD, CEO , NCO Services
Anne Tumlinson, Founder, Anne Tumlinson Innovations, LLC

Find this session’s presentation materials here.

LTC Comment: Bottom line, there isn’t enough money in the system to make this a significant benefit, but it could convey the idea to the public that they have a meaningful new benefit, which they do not. The importance of the change is that it removes the traditional requirement that Medicare benefits must be medical in nature and universal (available to everyone). Offering non-medical benefits that can be targeted to certain individuals and groups but not others is a major, and some might say worrisome, departure from long-standing Medicare policy. Camel’s nose under the tent?

  

Mon, March 25th, 12:15 PM - 12:45 PM
Demo - My Million Dollar Mom
During the lunch break, Ross Schriftman showed and discussed the movie he wrote and produced about caring for his mother through her Alzheimer’s Disease. Check it out here. Ross is using the movie to make people aware of the personal and financial risks of dementia and the importance of planning ahead.

  

Mon, March 25th, 2:00 PM - 3:15 PM
Become an LTCI Super Hero: Integrating Asset-Based into Traditional LTCI Presentation
Producers & Sales Track

Description: Learn from a panel of top producers how they have successfully merged the two product types to provide a comprehensive and effective client presentation and experience. This team of presenters – LTC Wonder Women and Supermen – will share proven approaches and techniques you can adapt to boost your sales.

Session Producer: Andrew Herman, FSA, MAAA, President, AH Insurance Services, Inc. 

Speakers:
Alecia Barnette, SVP - LTC, Fig Marketing
Margie Barrie, LTCP, CLTC, Senior LTC Consultant, ACSIA Partners
Steven Cain, CLTC, CSA, Director, LTCI Partners, LLC
Mary Ann DeKing, Long Term Care Specialist, Plan and Care
Zach Derryberry, Director of Hybrid LTC Planning, ACSIA Partners
Find this session’s presentation materials here.

LTC Comment: This session addressed ways to integrate the sale of traditional and hybrid products. Key take-aways: don’t badmouth one kind of LTC insurance to sell the other. Treat them as complementary. Assess clients’ needs and propose the best options. Help the client navigate through the inherent complexity of the product. Be the expert.

  

Mon, March 25th, 3:45 PM - 5:00 PM
State Initiatives for LTC Financing Reform
Public Policy & Alternative Financing Solutions Track

Description: The National Academy of Social Insurance (NASI), as part of a larger project will soon release a comprehensive study on models for guiding states interested in social insurance initiatives for LTC finance reform. The report identifies the considerations states must evaluate including how various approaches would best enhance a private market role. Actuarial projections for various sample programs are included. This session will explore the analytic framework presented in the NASI report. It will also provide a brief update on the state-based initiatives underway in Washington, Maine, Michigan, California, Minnesota and others.

Session Producer: Eileen Tell, MPH, Independent Consultant, ET Consulting, LLC 

Speakers:
Eddie Armentraut, Consulting Actuary, Actuarial Research Corporation
Dr. Marc Cohen, PhD, Clinical Professor of Gerontology, University of Massachusetts
Allen Schmitz, FSA, MAAA, Principal and Consulting Actuary, Milliman, Inc.
Ben Veghte, Research Director, Caring Across Generations

Find this session’s presentation materials here.

LTC Comment: The wonderful thing about federalism is that individual states can try experimental programs (like these) and fail without causing a huge national waste of time and money like CLASS. This project’s goal of changing long-term care financing from a welfare-based system to social insurance, however, is highly problematical. First, the major social insurance programs we already have—Social Security and Medicare—are bankrupt. They face the inevitable economic outcome of all such Ponzi schemes. But even more fundamentally, social insurance undermines key personal values like independence and personal responsibility by spreading, but not pricing risk, thus rewarding poor behavior and punishing good behavior. After many decades of social insurance, we now see its inevitable consequences: too few people prepared to face retirement financially and the social insurance programs on which they’ve been taught to rely approaching insolvency. Ironically, the welfare approach to long-term care financing that this project aspires to replace has never been tried. The elephant in the room remains easy access to Medicaid by middle class and affluent people which is the real cause of the system’s dysfunction and LTCI’s low take-up. Pushing social insurance instead means trading the frying pan for the fire.

  

Tue, March 26th, 9:00 AM - 10:15 AM
What’s up Doc? Geriatric Neurology and the Implications for LTC Insurance
Public Policy & Alternative Financing Solutions Track

Description: A conversation with two of the nation’s leaders in geriatric neurology.

Key discussion topics will include:

  • Limitations in access to healthcare and current health provider attitudes that impact cognitive claims incidence

  • Issues with the cognitive diagnostic process

  • The dementia knowledge gap among healthcare professionals

  • The impact of dementia on fiduciary risks

  • The role of the family caregiver in cognitive situations

  • Current and new methods to assess cognition

  • The opportunity for recoverable cognitive claims including the use of technology to flag recoverable claims and help insureds age in place

  • De-risking dementia: opportunities for new products and services

Session Producer: John O'Leary, President, O'Leary Marketing Associates 

Speakers:
Neelum Aggarwal, MD, Associate Professor, Rush Medical Center
Dr. Anitha Rao, MD, MA, Chief Executive Officer and Founder, Neurocern
Lindsay Resnick, Wunderman

LTC Comment: This session was a fascinating discussion of dementia, what it is, what causes it, why drug development has been stymied, and the broadening research perspective on its relationship with nutrition, exercise and behavior. The link between heart and brain health; why women are more prone to Alzheimer’s Disease; inadequate geriatric training for physicians; the difference between dementia and delirium; a new approach to research that drops unpromising trials sooner; why patients are seeking help from insurers because they’re not getting it from harried health care providers.

  

Tue, March 26th, 10:45 AM - 12:00 PM
Evidence-Based Nutrition for Healthier Futures
Public Policy & Alternative Financing Solutions

Description: This session will feature three medical experts discussing how nutrition and healthy eating can help consumers, including long-term care insureds, lead healthier lives, and potentially mitigate conditions that lead to the need for long-term care. Lauren Biscotti, Director of External Development, Harvard Medical School, Dr. Monique Tello, primary care physician, author and healthy lifestyle advocate from Massachusetts General Hospital, and Dr. Neelum Aggarwal, a neurologist at Rush University Medical Center in Chicago and one of the nation’s pre-eminent experts on diagnosing and treating Alzheimer’s patients, will discuss their perspectives on evidenced-based nutrition practices their impact on future health.

Session Producer: John O'Leary, President, O'Leary Marketing Associates

Speakers:

Neelum Aggarwal, MD, Associate Professor, Rush Medical Center will discuss the status of several current nutritional studies that are underway including the MIND diet and their preliminary findings on changes that may positively impact cognition.

Lauren Biscotti, Director of Strategic Development, Harvard Medical School will discuss the new Harvard Medical School e-learning program- “6 weeks to Healthy Eating” and how it can help change consumer’s eating behaviors.

Dr. Monique Tello, MD, MPH, FACP, Instructor, Harvard Medical School, will provide a set of practical, easy to follow steps for both what to include and exclude from a healthy diet to prevent chronic diseases and also provide recipes that are both healthy and easy to make.

Find this session’s presentation materials here, here and here.

LTC Comment: Dementia and Alzheimer’s research are moving away from narrowly focusing on a single cause toward considering the effects of lifestyle, including diet, exercise, sleep, etc., on associated cognitive problems. Overall theme of the presentation: what is good for the heart is good for the brain. The goal is to turn risk factors into protective factors. It is ironic that healthy behavior leads to longer life which makes having a long-term chronic illness including dementia more likely over time. But if healthy living diminishes the risk of dementia, as this session argued, that irony is somewhat mitigated. This shotgun approach seems to me far more promising than the failed efforts to find and fix a single cause.

  

Tue, March 26th, 2:00 PM - 3:15 PM
Political Pundits Pontificate: The Political/Policy Environment in 2019
Public Policy & Alternative Financing Solutions Track

Description: After two plus years of a Trump White House and a Republican Congress, the situation changed dramatically last November. This session brings together some of the nation’s leading health, aging, and long-term care political and policy pundits to provide an update on the current political/policy situation in Washington. They will shed light on what the new landscape means for legislative and regulatory initiatives in financing and program delivery, for both public and private programs in long-term care and aging.

This session takes an interactive and entertaining approach to these challenging political topics by engaging the audience and putting our pundits on the spot to address a wide range of critical issues without sugar-coating or wishful thinking. This is a “tell-it-like-it-is” session designed to give us some strategic insights into the political realities within which we will be living for this year and next. There may even be some predictions for the 2020 elections.

Key topics will include what changed in terms of players and committee assignments and what that might mean for initiatives like the Chronic Care Act, Medicare for all, Medicaid re-structuring, caregiver support and the future of other aging, disability and long-term care programs.

Session Producer: John O'Leary, President, O'Leary Marketing Associates 

Speakers:
Bob Blancato, President, Matz, Blancato & Associates, Inc.
Richard Browdie, President/CEO, Benjamin Rose Institute on Aging
Joel White, Founder and President, Horizon Government Affairs
Tamera Luzzatto, Senior Vice President, The Pew Charitable Trusts

Find this session’s presentation materials here.

LTC Comment: Dominant conclusion of the panel: “Medicare for All” will go nowhere. No one in Washington wants to consider “pay fors.” State governors don’t have the luxury to ignore costs. They’re under pressure from constituents to fix things and that takes money. So they have to negotiate and compromise. Little of that happens in DC where the usual restraints on spending no longer seem to apply and the policy conversation is caustic. All panelists agreed the Mueller report made Trump stronger as a 2020 candidate, at least temporarily. Long-term care is America’s “denial issue.” Such focus as there is addresses “little pieces” of the problem. There’s no momentum and won’t be until the public demands attention to long-term care.

 

Tue, March 26th, 3:30 PM - 5:00 PM 

Alzheimer's Association Closing Session
General Conference Session

Description: Attendees will hear from Tom Doyle a member of the National Early-Stage Advisory Group (ESAG) helping to bring the voice of individuals living with dementia to the national forefront. Keith Fargo the Director of Scientific Programs & Outreach for the Alzheimer's Association will discuss the breadth of Association-led research initiatives that span the mission. He will also address how science and programs intersect around research including POINTER and LEADS. Sam Fazio, Senior Director of Quality Care and Psychological Research for the Alzheimer's Association will report on the financial literacy research that is currently being done as a result of a grant program. This Session Sponsored by OneAmerica.

Speakers:
Tom Doyle, National Early Stage Advisor, Alzheimer's Association
Keith Fargo, Ph. D., Director of Scientific Programs & Outreach, Alzheimer's Association
Sam Fazio, PhD, Senior Director of Quality Care and Psychosocial Research, Alzheimer's Association

LTC Comment: The highlight of this session was the opening speaker, Tom Doyle. Tom has both Alzheimer’s Disease and Parkinson’s. He recounted how his life was turned upside down by these ailments as he could no longer carry on his work as a college professor and he felt like he was losing all reason for living. But now, with the help of his husband, Levi, and having been given new purpose as a spokesman for the Alzheimer’s Association, Tom is thriving with a new sense of purpose and personal satisfaction. Presentations like Tom’s help an audience imagine what having dementia would be like and hopefully awaken people to the need to prepare for this eventuality for themselves and for their loved ones. The remainder of the session addressed the status of Alzheimer’s and dementia research with all the material presented mentioned, accessible at the Alzheimer’s Association’s website.

  

Tue, March 26th, 7:30 PM - 9:00 PM
Whirled News Tonight Improv Show
General Conference Session 

Description: Cocktails begin at 7:30 - Show begins at 7:45pm.
Our Tuesday evening entertainment will feature performers from Chicago’s Best Improv Comedy Theater – Improv Olympic! Improv Olympic will be bringing a seven person cast of performers to entertain the attendees of the ILTCI. The performance will be approximately 60 – 80 minutes in length. “ iO” is recognized as the birthplace of “long-form” improv and is home to some of the best improv comedy shows in the country. They have helped to train and develop an entire generation of America’s best and brightest comedic entertainers for over 30 years. Alumni include past and present cast members of Saturday Night Live and stars of some of your favorite small screen prime-time comedy and late-night shows – along with others who have gone on to write, direct and produce blockbuster Hollywood movies. This interactive show will include performance pieces including musical games, scenes that solve the audience’s problems and their signature piece, THE DREAM, based on the day in the life of one of the audience members. To learn more about iO, visit https://www.ioimprov.com/ It will be a improve show of Olympic proportions…we hope to see you there!

LTC Comment: And a good time was had by all at this closing session of the conference. Stay tuned to LTC Bullets for information about the 20the ILTCI Conference in Denver, Colorado March 29 to April 1, 2020 as it becomes available.