Financing Long-Term Services and Supports for Individuals with Disabilities and Older Adults: A Workshop

When: June 12, 2013 (9:00 AM Eastern)
Where: National Academy of Sciences Building (Lecture Room) • 2101 Constitution Avenue, NW, Washington, DC 20418

Topics Aging, Health Services, Coverage, and Access, Health Care Workforce
Activity: Forum on Aging, Disability, and Independence
Boards: Board on Health Sciences Policy, Division of Behavioral and Social Sciences and Education

An agenda will be available soon.

While both medical and social services play important roles in keeping seniors and adults with disabilities in the setting of their choice in the community, there is often a disconnect between these two systems. Underpinning all aspects of successful community living and independence for people who are aging and/or with disabilities is the importance of a holistic person-centered planning process that addresses health and long term services and support needs in a manner that reflects individual preferences.  Self-direction is a service model that empowers participants and their families by expanding their degree of choice and control over the services and supports they need to live at home. Self- or participant-direction spans all service delivery systems, including public benefit programs, managed care, and private-pay long-term insurance settings.
In that regard, the financing of long-term services and supports (LTSS) has become a significant issue for these populations and the country as a whole.  These are the type of services that an individual needs assistance with in order to live independently (e.g., eating, bathing, dressing), and does not include medical/nursing services required to manage health conditions. About 11 million adults (age 18 and over) receive LTSS, and only a little more than half (57 percent) are over age 65.  In 2011, $210.9 billion was spent on LTSS (about 9.3 percent of person health care spending). About 2/3 of that spending came from Medicaid ($131.4 billion) and nearly 22 percent came from out-of-pocket spending by individuals and their families ($45.5 billion).  Medicare plays no role in financing LTSS and relatively few people have purchase private long term care insurance (about 6-7 million policies currently).  With the projected demographics for the aging of our population, these numbers are expected to increase exponentially.

The workshop will feature invited presentations and discussions that will:
• Provide an overview of the scope and trends of current sources of financing for long-term services and supports for working-age individuals with disabilities and older adults aging into disability, including income supports and personal savings
• Consider the role of families, business, and government in financing long-term services and supports
• Discuss implications of and opportunities for current and innovative approaches

Most care received by people with disabilities is provided by families and friends without compensations.  Various studies have estimated the value of these services at hundreds of billions of dollars, yet this is usually not counted when thinking about financing of LTSS.  Other important issues that usually escape attention in discussions of financing LTSS include the inadequate planning and personal savings for long-term care needs by individuals, intergenerational transfers, the role of income support programs like social security disability income (SSDI) and supplemental security income (SSI), and the role of short- and long-term disability insurance plans.  This workshop seeks to provide a more comprehensive understanding of all the financial sources of long-term services and supports.

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