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LeadingAge report: Options for LTSS financing makeover

February 19, 2016
by Pamela Tabar, Editor-in-Chief
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Long-term care supports and services (LTSS) desperately needs new financing models, especially insurance-based options, says a new report from LeadingAge.

The report, “Perspectives on the Challenges of Financing Long-Term Care Services and Supports,” representing the ongoing work of the Pathways Task Force, explored three different alternatives to current funding models for LTSS, a segment of care that often falls in the gap between Medicare coverage and personal insurance coverage.

Future models need to be self-sustaining, affordable and free from pre-existing condition restrictions, the report says. Above all, the new financing models should avoid not putting unnecessary burdens on the already overtaxed Medicaid system, which has somehow become “the default payer” for under-income adults, the report notes.

Although the report acknowledges that there is no silver bullet to the LTSS financing problem, insurance-based options may have the most promise, it concludes. Working with insurers to create new models for long-term care insurance would allow families a way to plan ahead for future care costs, especially for people with disabilities or early onset Alzheimer’s. But nurturing those insurance options could be challenging, as many insurers have run away from the long-term care insurance sector in recent years.

LeadingAge calls the current LTSS funding models “unsustainable, irrational and unfair for individuals and families,” and echoes the pleas for sensible options that don’t over-burden the Medicaid system, said LeadingAge President and CEO Katie Smith Sloan in a recent blog posting.

“LeadingAge has long believed that the current financial infrastructure supporting LTSS is broken,” Sloan  added in a statement about the new report. “The research tells us that there are solutions to help families and individuals protect themselves against potential LTSS costs, and solutions that provide relief to the Medicaid program through creative public and private sector options.”

AARP and the SCAN Foundation also contributed funding for the study.