Recent studies have found that more than half of middle-income seniors will not be able to afford the care they need, and 15% of baby boomers will incur more than $250,000 in long-term care costs. If anything, the COVID-19 pandemic exposed the market failures and funding gaps in providing long-term care even further.
In response, nonprofit think tank the Milken Institute on Wednesday released a new report highlighting innovative public and private sector solutions that can expand long-term care access and delivery for middle-income Americans.
Published in collaboration with Genworth, the report, “New Approaches to Long-Term Care Access for Middle-Income Households,” examines financing, technology and care challenges of the current system and offers recommendations to overcome these barriers.
“The pandemic has brought greater awareness to the fault lines that exist in the current long-term care ecosystem,” said Tom McInerney, president and CEO of Genworth. “The concrete recommendations outlined in this report are critical to closing the gaps in providing much-needed, meaningful long-term care solutions for millions of middle-income individuals.”
Some of the Milken Institute’s specific recommendations:
- Design a large-scale demonstration project to better analyze costs and benefits of various technology solutions that enhance home-based care. The authors noted that numerous private sector pilot programs exist measuring the effectiveness of solutions such as telehealth and remote monitoring, but they do not use standardized data and evaluation frameworks. The report offers insights into how to develop a cohesive demonstration project and outlines specific parameters such as demographic profile, evaluation measures and potential funding sources for successful program design.
- Expand access to integrated care for middle-income Americans who cannot afford specialized private care programs and do not qualify for Medicaid. The report recommends scaling up promising integrated care programs that are already available in the marketplace, such as Special Needs Plans and Programs of All-Inclusive Care for the Elderly, known as PACE for short. Proposed modifications include offering a new community-based SNP or expanded access to PACE via a tiered benefit structure, providing broader access to non-medical supportive services to a broader cohort of Americans.
- Develop new complementary public-private insurance solutions that offer seamless, affordable coverage and segment risk.
“Long-term care is too costly for the private or public sectors to tackle alone,” the report authors wrote. In an effort to mitigate costs and associated risks, the Milken Institute identified a new approach that allows the public sector to develop long-term care insurance programs that address the first couple of years of long-term care costs, followed by complementary private sector long-term care insurance products that provide coverage for additional years. For the most prolonged and expensive cases, Medicaid would continue to act as a backstop.
“These innovative solutions can improve access to high-quality care for older adults while driving down costs for public and private payers alike,” said Caitlin MacLean, senior director of innovative finance at the Milken Institute.
