Public Policy and the Demand for Long-Term Care Insurance

公共政策和长期护理保险的需求

• 批准号: 8212656
• 负责人: DAVID C GRABOWSKI
• 金额: $ 32.75万
• 依托单位: HARVARD MEDICAL SCHOOL
• 依托单位国家: 美国
• 财政年份: 2011
• 资助国家: 美国
• 起止时间: 2011-09-15 至 2013-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8212656
• 关键词: Accounting; Acute; Age; Attitude; Caring; Characteristics; Charge; Data; Databases; Demographic Factors; Disability Insurance; Elderly; Eligibility Determination; Enrollment; Family; Future; Government; Government Financing; Growth; Health; Incentives; Income; Individual; Insurance; Laws; Lead; Left; Light; Link; Long-Term Care; Long-Term Care Insurance; Marketing; Medicaid; Medical; Medicare; Modeling; Myopia; Nature; Participant; Patients; Persons; Play; Policies; Population; Program Sustainability; Public Policy; Relative (related person); Research; Research Infrastructure; Research Personnel; Resort; Retirement; Risk; Role; Services; Shapes; Simulate; Source; State Government; Structure; Supportive assistance; Surveys; Taxes; Time; Uncertainty; United States; care systems; caregiving; community living; cost; design; early experience; expectation; experience; insight; meetings; novel; payment; programs; public-private partnership; safety net; success; trait

DESCRIPTION (provided by applicant): The financing of long-term care is an increasingly important issue for the elderly and our population as a whole. We propose to use two novel databases to study the demand for long-term care insurance (LTCi) and to consider the potential role of governmental policy moving forward. These data include multiple waves of detailed survey information on buyers and non-buyers of LTCi policies and longitudinal enrollment and utilization data from the state Long-Term Care Partnership Program, a public-private partnership between states and insurance companies designed to reduce Medicaid spending by delaying or eliminating the need for some people to rely on Medicaid for long-term care services. Relative to previous research, we will have much more detailed information on individuals' attitudes and opinions about long-term care, family caregiving, and related government policies; the primary reasons for purchase/non-purchase of LTCi; and demographics factors relevant to purchase decisions, including asset and income levels. For LTCi buyers, these detailed survey data are linked to information on level of policies that were purchased. Thus, our first two research aims are to analyze the effect of individual factors, such as demographic traits and attitudes about the intertwined roles of family caregiving, Medicaid, and private insurance, and state-level factors, such as Medicaid eligibility policies, tax incentives, and the presence of a Partnership Program, on 1) the purchase of LTCi and 2) the level of LTCi policy that was purchased. Both of these analyses will use person-level survey data merged with state-level policy factors to model the effect of individual and state traits on LTCi purchase. The analyses will exploit the longitudinal nature of the survey data (surveys were conducted in 1990, 1995, 2000, 2005, and 2010) to account for unobserved, time invariant state characteristics that may be correlated with both LTCi purchase and state policy features (e.g., tax incentives for LTCi). Understanding the key determinants of individuals' decision to purchase LTCi can help shape relevant government policies and marketing campaigns, including product targeting for the Community Living Assistance and Supportive Services (CLASS) program. The third aim of our project is i) to describe the early experience of state Long- Term Care Partnership Programs in terms of the number and type of policies sold and the claims experience of enrollees and ii) to simulate the potential effect of these programs on future Medicaid long-term care spending. To accomplish these aims, we will use detailed information on policies, policyholders, and claimants available from all state LTC Partnership Programs merged with information from the 2010 LTCi buyers survey (e.g., the asset/income levels of purchasers of Partnership policies) and long-term care utilization data from similar individuals in the Health and Retirement Survey. Evaluating the early experience of state Partnership programs can help shape expectations for the program going forward, particularly around its ability to impact Medicaid spending. PUBLIC HEALTH RELEVANCE: To date, private long-term care insurance has played a minimal role in financing long-term care in the United States; instead, out of pocket payments and public financing through state Medicaid programs have played primary roles, leaving individuals, families, and state governments vulnerable to the potentially catastrophic costs of long-term services and supports. We propose to use two key databases to study the factors influencing the demand for long-term care insurance and the role of government policy moving forward, including multiple waves of survey data from buyers and non-buyers of LTCi policies and longitudinal enrollment and utilization data from the Long-Term Care Partnership Program, a public-private partnership between states and insurance companies designed to reduce Medicaid spending by delaying or eliminating the need for some people to rely on Medicaid for long-term care services. By shedding light on key factors that influence the demand for insurance and the early experience of the LTC Partnership program, our analyses will offer key insights for policymakers as they implement and refine the government's approach to financing long- term care in the future.

描述（由申请人提供）：长期护理的融资是老年人和我们整个人口的越来越重要的问题。我们建议使用两个新颖的数据库研究长期护理保险（LTCI）的需求，并考虑政府政策向前发展的潜在作用。这些数据包括有关LTCI保单的买家和非购买者的详细调查信息，以及来自州长期护理合作伙伴计划的纵向注册和利用数据，这是州和旨在减少医疗补助支出之间的公私合作伙伴关系，通过延迟或消除某些人依靠医疗服务来减少医疗补助来进行长期护理服务的保险公司。相对于以前的研究，我们将获得有关个人对长期护理，家庭护理和相关政府政策的态度和意见的更详细信息； LTCI购买/非购买的主要原因；和人口统计因素与购买决策有关，包括资产和收入水平。对于LTCI买家，这些详细的调查数据与购买的政策级别有关。因此，我们的前两项研究的目的是分析个人因素的影响，例如人口特征和关于家庭护理，医疗补助和私人保险和州级因素的相互交织角色的态度，以及医疗补助的资格政策，税收激励措施，税收激励措施，以及在1）购买LTCI和2）ltci ltci ltci ltci的购买。这两种分析都将使用与州级政策因素合并的人级调查数据来模拟个人和州特征对LTCI购买的影响。这些分析将利用调查数据的纵向性质（调查是在1990年，1995年，2000年，2005年和2010年进行的），以说明尚无观察的，时间不变的状态特征，这些特征可能与LTCI购买和国家政策特征均相关（例如，LTCI的税收激励剂）。了解个人购买LTCI决定的关键决定因素可以帮助塑造相关的政府政策和营销活动，包括针对社区生活援助和支持服务（班级）计划的产品。我们项目的第三个目标是i）描述出售政策的数量和类型以及参与者的索赔经验以及II）的早期经验，以及II）模拟这些计划对未来的Medicaid长期护理支出的潜在影响。为了实现这些目标，我们将使用有关所有州LT​​C合作计划可用的政策，保单持有人和索赔人的详细信息，这些信息与2010年LTCI买家调查的信息合并（例如，合伙政策的购买者的资产/收入水平）和从健康和退休调查中的相似个人中的长期护理利用数据的资产/收入水平。评估国家伙伴关系计划的早期经验可以帮助塑造对计划的期望，尤其是围绕其影响医疗补助支出的能力。 公共卫生相关性：迄今为止，私人长期护理保险在美国的长期护理融资中发挥了最小的作用；取而代之的是，通过州医疗补助计划的零钱和公共融资已经发挥了主要作用，使个人，家庭和州政府容易受到长期服务和支持的潜在灾难性成本的影响。我们建议使用两个关键数据来研究影响长期护理保险需求的因素以及政府保单的发展，包括来自购买者和非LTCI保单的非购买者的多浪调查数据，以及从长期护理合作伙伴关系中，为某些人提供了依靠的保险公司，以延迟医学上的依赖的依赖的公司依赖的公司，并使用纵向招生和纵向使用数据，并利用纵向数据。长期护理服务。通过阐明影响保险需求和LTC合作伙伴计划的早期经验的关键因素，我们的分析将为政策制定者提供关键的见解，因为他们在未来实施和完善政府为长期护理提供融资的方法。