McCormack Speaks

February 22, 2018
by McCormack Speaks
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Gerontology Professor Marc Cohen Presents New “Policy Roadmap” for Future of LTSS Finance

This post originally appeared on the Gerontology Institute blog, written by Steven Syre.

What would a better way to finance long-term services and supports (LTSS) for older Americans really look like? Even more importantly: How would it perform?

Marc Cohen, co-director of the LeadingAge LTSS Center @UMass Boston, and two colleagues took up that challenge and developed a new “policy roadmap” combining public catastrophic insurance with gap-filling private LTSS insurance focused on middle-income people.

“The fundamental LTSS financing problem is the absence of an effective insurance mechanism to protect people against the cost of extensive LTSS they may require over the course of their lives,” said Cohen, also a professor at UMass Boston’s McCormack Graduate School.

Cohen and co-authors Judith Feder, a professor at Georgetown University’s McCourt School of Public Policy and a fellow at the Urban Institute, and Melissa Favreault, a senior fellow at the Urban Institute, said their plan would enhance benefits for people with long-duration impairments, reduce unmet LTSS needs and mitigate burdens facing family caregivers.

The authors said their plan would enhance LTSS spending by 14 percent, reduce out-of-pocket spending by 15 percent and cut Medicaid spending by 23 percent, compared to projected spending under current law.

The public-insurance element of the plan would be financed with a 1 percent Medicare tax surcharge paid by taxpayers over the age of 40.

The authors described their proposal as providing an “analytical foundation for demonstrating how a shift from an LTSS system dependent on impoverishment and last-resort public financing to a financially sound insurance system that can provide meaningful protection for people with catastrophic LTSS needs.”

Cohen and Feder presented their plan at a Jan. 31 discussion hosted by the Bipartisan Policy Center. They were joined on a panel by Gretchen E. Alkema, vice president of policy and communication at The SCAN foundation; Sheila Burke, a BPC fellow and strategic advisor at Baker Donelson; Cindy Mann, the former director of the Center for Medicaid and Anne Tumlinson, the founder of Daughterhood.

Under the plan, eligibility for public catastrophic coverage would be subject to waiting periods at age 65 ranging from one to four years, based on income. Higher earners would be subject to longer waiting periods.

Private insurance would offer a way to cover those up-front gap years. Based on the average cost of private policies on the individual market, the authors estimate gap-filling coverage would amount to 2-4 percent of income for all groups, except the lowest 20 percent of earners. Such costs are in the range of what people appear to be willing to spend for policies, according to the authors.

Individuals assessed with two or more limitations in activities of daily living or severe cognitive impairment expected to last longer than 90 days would qualify for public benefits once they satisfy the waiting period.

The model’s level of benefit payments is linked to direct service costs, excluding room and board. It would provide $110 per day, which was the average expense for five hours of service by home health aide in 2016 (though the benefit could be spent on nursing home care as well).

The authors said the 1 percent Medicare surcharge helping to finance the program would cost a worker earning the 2016 average covered wage of $48,642 about $41 per month, or when split evenly between employees and employers, about $21 in direct monthly costs to employees. They suggested the surcharge could be presented as a premium and taxpayers could be offered the opportunity to opt out of the plan.

Cohen and his co-authors acknowledged that the search for better ways to finance long-term services and supports is not high on America’s current political agenda. But they believe work on the issue now can pay dividends in the future.

“Research undertaken now on the design and challenges of specific proposals for LTSS financing reform will provide the necessary intellectual infrastructure and foundation for effective action when policymakers are inevitably forced to address the issue in the years ahead,” they wrote.

January 13, 2018
by McCormack Speaks
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Building Academic Relationships in China to Address Growing Elder Population

This post originally appeared on the Gerontology Institute blog.

Professor Jan Mutchler with student Yu Mengting of Renmin University.

Professor Jan Mutchler with student Yu Mengting of Renmin University.

UMass Boston Gerontology professors Jeffrey Burr and Jan Mutchler delivered presentations at a conference hosted by China’s Remin University and other organizations in December. That was not especially big news.

But their speeches, as well as social events organized around the visit to China, were important just the same. Their trip was the latest of many small steps the Department of Gerontology at UMass Boston’s McCormack Graduate School has taken to build academic relationships in a country with one of the world’s biggest and fastest growing elder populations.

“This initiative is part of our effort to ‘look outward’ beyond the boundaries of the United States when it comes to gerontology research, teaching, and service,” said Burr, the department chair. “Countries in East Asia, like China, provide a wonderful opportunity to learn about the aging process through different cultural, social, and economic lenses.” Continue reading.

January 11, 2018
by McCormack Speaks
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UMass Boston Gerontology Contingent Follows Research Projects to South Korea

This post originally appeared in the Gerontology Institute blog written by Steven Syre.

Image of professor and students in South Korea

(L-R) Bon Kim, assistant professor Kyungmin Kim, associate professor Kathrin Boerner, and Yijung Kim at Seoul National University.

A small contingent of UMass Boston Department of Gerontology professors and students were simply following their work wherever it led. In this case, it took them nearly 7,000 miles to South Korea.

The group included Associate Professor Kathrin Boerner and Assistant Professor Kyungmin Kim, as well as PhD candidates Yijung Kim and Bon Kim. They spent two weeks recently in Seoul, working on a series of projects related to South Korea’s aging population and making presentations organized around their visit. Continue reading.

January 4, 2018
by McCormack Speaks
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How Housing Plus Services Addresses Senior Needs

This post originally appeared on the Gerontology Institute blog.

By Meghan Hendricksen

man with suitcase heading to nursing homeA shortage of affordable housing for seniors will pose a huge challenge for the United States in the years ahead. But finding homes for those elders is only part of the solution, according to Alisha Sanders.

Helping seniors deal with health issues locally and age in place in their homes should be an important element of any housing plan, she said.

Sanders, director of Housing & Services Policy Research at LeadingAge, was the final fall speaker series guest at McCormack Graduate School’s Department of Gerontology. Her talk, “Affordable Senior Housing Plus Services: Meeting the Needs of Low-Income Seniors,” stressed the value of providing housing and services together. Continue reading.

November 13, 2017
by McCormack Speaks
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Panel Recommends Ways to Improve Identification, Treatment For Hospital Patients With Dementia

This post originally appeared on the UMass Boston Gerontology Institute blog, written by Steven Syre.

puzzle pieces depicting woman with dementiaHospitalization is a stressful experience for most patients. But a person with dementia typically needs three days to recover pre-hospital function for each day hospitalized.

That caution has always stuck with Nina Silverstein, a professor of Gerontology at UMass Boston’s McCormack Graduate School. She kept it in mind as a member of a state Alzheimer’s and Related Dementias Acute Care Advisory Committee.

The 16-member committee recently published its recommendations for Massachusetts hospitals treating patients with dementia. Their report is intended to drive future discussion that will ultimately shape best practices to identify dementia and/or delirium and adjust care plans accordingly. Read more.

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