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Public Policy and the Demand for Long-Term Care Insurance

公共政策和长期护理保险的需求

基本信息

批准号：
8332862
负责人：
DAVID C GRABOWSKI
金额：
$ 31万
依托单位：
HARVARD MEDICAL SCHOOL
依托单位国家：
美国
项目类别：
财政年份：
2011
资助国家：
美国
起止时间：
2011-09-15 至 2014-08-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8332862
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

项目摘要

PROJECT ABSTRACT 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.

项目摘要长期护理的筹资对老年人和我国全体人口来说是一个日益重要的问题。我们建议使用两个新的数据库来研究长期护理保险(LTCi)的需求和考虑未来政府政策的潜在作用。这些数据包括多波关于LTCi保单购买者和非购买者的详细调查信息以及纵向投保和来自州长期护理伙伴关系计划的利用数据，这是一个公私合作伙伴关系各州和保险公司旨在通过推迟或消除对一些人依赖医疗补助提供长期护理服务。相对于之前的研究，我们将有更多的更详细地了解个人对长期护理、家庭护理和相关政府政策；购买/不购买LTCi的主要原因；以及人口统计数据与购买决策相关的因素，包括资产和收入水平。对于LTCi买家，这些详细的调查数据链接到有关购买的保单级别的信息。因此，我们的前两项研究目的是分析个人因素的影响，如人口统计特征和对家庭照料、医疗补助和私人保险的相互交织的作用，以及州一级的因素，如医疗补助资格政策、税收优惠和合作伙伴计划的存在，1)购买 LTCI和2)购买的LTCi策略的级别。这两项分析都将使用个人层面的调查将数据与州一级的政策因素合并，以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(1990年、1995年进行调查， 2000、2005和2010)来解释可能相关的未观察到的、时间不变的状态特征同时具有LTCi购买和国家政策特征(例如，LTCi的税收优惠)。了解关键所在个人购买LTCi的决定因素可以帮助形成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的产品定位服务(类)计划。我们项目的第三个目的是i)描述国家长期的早期经验定期护理合作伙伴计划-销售的保单数量和类型以及索赔经验第二，模拟这些计划对未来医疗补助长期护理支出的潜在影响。为了实现这些目标，我们将使用有关保单、投保人和索赔人的详细信息。所有州的LTC合作伙伴计划与2010年LTCi买家调查的信息合并(例如，伙伴关系保单购买者的资产/收入水平)和长期护理利用数据健康和退休调查中的个人。评价国家伙伴关系的早期经验计划可以帮助形成对计划未来的期望，特别是围绕其影响的能力医疗补助支出。