LTC Bullet:  LTC Almanac Update

Tuesday, March 29, 2011

Seattle--

LTC Comment:  Our latest update to the "LTC Almanac" in The Zone follows the ***news.***

*** SPECIAL.  In appreciation for Claude Thau's sponsorship of today's LTC Bullet we are making access to The Zone, including the "Almanac of Long-Term Care" free for one week.  To access this introductory peek into The Zone, go to http://www.centerltc.com/members/index.htm and use the following case-sensitive user name and password:  UN: IntrotoZone / PW: FreeTrial.  Like what you see?  Then join the Center for Long-Term Care Reform here. ***

*** 2011 MEDICAID/MEDICARE NUMBERS.  Want to know what the Medicaid Spousal Impoverishment Standards and the Medicare Deductibles and Co-Insurance figures are for 2011?  We've just updated the information in The Zone here.  You'll need your User Name and Password to enter The Zone.  Check with Damon at 206-283-7036 or damon@centerltc.com if you need a reminder or to join the Center and get access to this cornucopia of information in The Zone. ***

*** MEDICAID FLAT/MEDICARE UP.  Because there was no Social Security cost of living increase in 2010 or 2011, the Medicaid spousal impoverishment protection numbers stayed flat.  But Medicare's co-insurance and deductible numbers continue their steady annual increase.  This is just one more example of the eligibility noose tightening on all federal welfare and social insurance programs.  Keep an eye out for others. ***

LTC BULLET:  LTC ALMANAC UPDATE

LTC Comment:  Center members know and appreciate our "Almanac of Long-Term Care" in The Zone, our password-protected website.  

The LTC Almanac is divided into 11 sections:

Aging Demographics 
International 
Unfunded Liabilities--Social Security, Medicare, and Budgets 
Long-Term Care 
Caregiving 
Long-Term Care Financing 
Long-Term Care Insurance 
Reverse Mortgages 
Long-Term Care Providers 
Medicaid 
Medicaid Planning   

Each section is divided into sub-sections and under each sub-section we provide a list by date of the most important reports and articles published on the topic, usually with a few highlights.

The Almanac of Long-Term Care is a great way to find statistics you need quickly or to get current on topics you need to know the latest information about.

The Zone and the LTC Almanac are for Center for Long-Term Care Reform members only, except during this week's free trial offer.  Join the Center here:  http://www.centerltc.com/support/index.htm.  Call or email Damon at 206-283-7036 or damon@centerltc.com.  He can give you a user name and password to open up The Zone even before your annual dues payment arrives.  Individual annual memberships are $150 and corporate memberships with many extra benefits start at $1,000.  See our "Membership Levels and Benefits" schedule here.

Caveat:  With time, some hyperlinks go bad.  In a huge document like the "LTC Almanac," we can't keep all the links current all the time.  If you find a bad link, but want to get to the material, contact us.  We often have an electronic copy of the document and we can usually find a current live link.  We'll also fix the link in the LTC Almanac so it will be current again for others.

LTC Almanac Update

Chapter 1:  Aging Demographics

United States

General Stats

Older Americans 2010--Key Indicators of Well-Being URL:  http://www.agingstats.gov/agingstatsdotnet/Main_Site/Data/2010_Documents/Docs/OA_2010.pdf
See LTC E-Alert #10-084:  New Compilation of Aging Statistics, Wednesday, July 21, 2010

Boomer Generation Characteristics

Allianz Reclaiming Future Study 0610 URL:  https://www.allianzlife.com/Variable/content/public/Literature/Documents/ENT-991.pdf "The Allianz Reclaiming the Future Study was conceived to be one of the most comprehensive examination of baby boomers' preparation for and expectations of retirement." Download the White Paper (pdf):  https://www.allianzlife.com/Variable/content/public/Literature/Documents/ENT-991.pdf  Download the Executive Summary (pdf):  https://www.allianzlife.com/Variable/content/public/Literature/Documents/ENT-993.pdf

Chapter 2:  International

Global Aging

Global Aging and the Crisis of the 2020s 1210 URL:  http://csis.org/files/publication/110104_gai_jackson.pdf
“The risk of social and political upheaval could grow throughout the developing world—even as the developed world’s capacity to deal with such threats declines.”

Countries 

England:

British LTCI 1010 URL:  http://www.abi.org.uk/Publications/52323.pdf
"If your personal assets are more than £23,250, you will normally be expected to pay for the full cost of long term care yourself, although you may still be entitled to some state benefits that are not means-tested."

Chapter 3:  Unfunded Liabilities--Social Security, Medicare, and Budgets

GAO on Unfunded Liabilities

"The Federal Government's Long-Term Fiscal Outlook  January 2011 Update," United States Government Accountability Office:  Quote:  "GAO’s long-term simulations show that even as the economy recovers and policies to stimulate the economy wind down, the outlook is for large and growing deficits."

Unfunded Liability Estimates

KFF on Medicare Trustees 0810 URL:  http://www.kff.org/medicare/upload/7305-05.pdf
*** UPDATED MEDICARE FACT SHEET Reflects New Medicare Solvency Data.  Tuesday, August 10, 2010.  The Kaiser Family Foundation's Medicare Spending and Financing fact sheet has been updated to reflect changes in the latest financial projections for Medicare from the 2010 Medicare Trustees Report. The report incorporates reductions in the rate of growth of Medicare spending, attributable to the 2010 health reform law. The fact sheet includes an updated estimate showing the law will extend the solvency of the Medicare Part A Hospital Insurance Trust Fund until 2029, 12 years later than was projected in last year’s report.  The fact sheet is available online at http://www.kff.org/medicare/7305.cfm." 
LTC Comment:  Take this with a grain of salt.  For reasons we've covered here and will again, claims the Medicare "trust fund" has a longer lease on life are specious.  See "The $50 Trillion Sleight of Hand." ***

Critical analysis of 2010 trustees report: 
Medicare Unfunded Liabilities, NCPA 1110 URL:  http://www.ncpa.org/pdfs/st330.pdf
"Medicare Trustees Reports 2010 and 2009: What a Difference a Year Makes, Policy Report No. 330 by Andrew J. Rettenmaier and Thomas R. Saving, National Center for Policy Analysis, October 2010
"News that's too good to be true," by John Goodman, NCPA
"The $50 Trillion Sleight of Hand," Thursday, August 12, 2010, by Steve Moses
"Medicare Trustees Issue Report Disavowed by Chief Actuary," by J. D. Foster, Ph.D. 

Live hyperlink to:  2010 ANNUAL REPORT OF THE BOARDS OF TRUSTEES OF THE FEDERAL HOSPITAL INSURANCE AND FEDERAL SUPPLEMENTARY MEDICAL INSURANCE TRUST FUNDS, 8/5/10  http://www.cms.gov/ReportsTrustFunds/downloads/tr2010.pdf

Chapter 4:  Long-Term Care

Home and Community-Based Services

Adult Day Services by MMMI 1010 URL:  http://www.metlife.com/assets/cao/mmi/publications/studies/2010/mmi-adult-day-services.pdf
A summary of the study's findings in the Sacramento Bee said: "Nearly half of family members serving as primary caregivers to loved ones have either lost a job or missed career opportunities as a result of their care giving responsibilities, finds a new study by Genworth Financial (Genworth) . . . [and] more than four in ten primary caregivers experience an increase in stress with their spouse and nearly three in ten report stress with siblings."
See also LTC E-Alert #10-121:  Two Reports You Should Review, Wednesday, October 13, 2010:  http://www.centerltc.com/members/e-alerts/ltc_ea10-121.htm

Chapter 5:  Caregiving

General

MetLife Caregiving Study 0210 URL:  http://www.metlife.com/assets/cao/mmi/publications/studies/2010/mmi-working-caregivers-employers-health-care-costs.pdf
"The MetLife Study of Working Caregivers and Employer Health Care Costs"
See also:  LTC E-Alert #10-016:  Data Arrows for Your LTCI Quiver, Thursday, February 4, 2010

Caregiver Stress and Burnout

Beyond Dollars--True Cost of Caregiving 0910
"Beyond Dollars: The True Impact of Long Term Caring"  Research findings on the circle of care and the impact on the many people within it.  Genworth report.

Chapter 6:  Long-Term Care Financing

Nursing Home and Home Care Expenditure Data from CMS and Health Affairs

2008 Data and 2009-2019 projections:

CMS Tables:  http://www.cms.hhs.gov/NationalHealthExpendData/downloads/tables.pdf
Health Affairs URL:  http://content.healthaffairs.org/cgi/content/full/29/1/147
LTC Bullet:  So What If the Government Pays for Most LTC?, 2008 Data Update, Wednesday, January 13, 2010:  http://www.centerltc.com/bullets/archives2010/855.htm
Health Affairs on Spending Projections:  2009-2019 URL:  http://content.healthaffairs.org/content/early/2010/02/04/hlthaff.2009.1074.abstract

Past Budget Crises as Prologue

AARP on Weathering the Storm 0111URL:  http://assets.aarp.org/rgcenter/ppi/ltc/CURRENT__Budget_Paper_v9Jan6.pdf

"This report is the most comprehensive analysis to date on the budget cuts to both Medicaid and non-Medicaid–funded long-term services and supports (LTSS) in each state. It also illustrates state-by-state how LTSS are financed. In addition, this study provides a very early snapshot of the likelihood of states pursuing some of the LTSS provisions within the Affordable Care Act (ACA). An individual state profile summarizing additional information obtained from each state that participated in the survey is located at www.aarp.org/ppi, www.healthmanagement.com, and www.nasuad.org."

Chapter 7:  Long-Term Care Insurance

General and Data

ILTCI Think Tank Report 031710 URL:  http://www.soa.org/files/pdf/ltc-2010-think-tank.pdf  "The intent of the Think Tank was to a) identify issues facing the LTC industry; b) prioritize these issues; c) brainstorm solutions to these issues; and d) identify specific next steps. To accomplish these goals, a list of invitees was developed. Invitees were chosen based on their industry position and with an eye toward representing a wide spectrum of disciplines and perspectives—actuaries, underwriters, sales; insurance companies, consultants, vendors, distribution companies."

How Much is Enough?

Healthy aging more costly 070910 URL:  http://crr.bc.edu/images/stories/Briefs/ib_10-8.pdf    May 2010, Number 10-8 "Does Staying Healthy Reduce Your Lifetime Health Care Costs?"  By Wei Sun, Anthony Webb, and Natalia Zhivan:
"Our main finding is that although the current health care costs of healthy retirees are lower than those of the unhealthy, the healthy actually face higher total health care costs over their remaining lifetime."
See also:  LTC E-Alert #10-078:  So Much for the Good Health Objection, Friday, July 9, 2010 

The CLASS Act

For comprehensive, frequently updated background on the CLASS Act, see "CLASS Act Update" in The Zone here: http://www.centerltc.com/members/ClassActUpdate-QuickReference.htm.

Dick Kaplan on CLASS Act 11/10 URL:  http://ssrn.com/abstract=1692288
"Financing Long-Term Care After Health Care Reform"

Heritage on CLASS 0710 URL:  http://thf_media.s3.amazonaws.com/2010/pdf/bg2441.pdf
"The CLASS Act: Repeal Now, or Face Permanent Taxpayer Bailout Later," James C. Capretta and Brian M. Riedl
See also LTC E-Alert #10-086: CLASS Doyenne Cops Out, Cashes In, Friday, July 23, 2010:  http://www.centerltc.com/members/e-alerts/ltc_ea10-086.htm

Chapter 10:  Medicaid

Medicaid is the 800-pound gorilla of LTC

POLICY REVIEW " NO. 153 " FEATURES:  The Forgotten Entitlements by Henry Olsen and Jon Flugstad:  http://www.hoover.org/publications/policy-review/article/5519
"Two little known entitlement programs, Social Security Disability Insurance (ssdi) and Medicaid Long Term Care (ltc), are also increasing at unsustainable rates. Call these the forgotten entitlements."  

Medicaid Financing

Medicaid LTC-The Ticking Time bomb 0610 URL:  http://www.deloitte.com/assets/Dcom-UnitedStates/Local%20Assets/Documents/US_CHS_2010LTCinMedicaid_062110.pdf
"A recent report by Deloitte titled "Medicaid Long-term Care: The ticking time bomb" gets the problem right, but the solution wrong."
See:  LTC E-Alert #10-069:  Right Time-Bomb, Wrong Solution, Tuesday, June 22, 2010