New Interactive Tool Offers Easy Access to Decades of Long-term Care Financing Proposals

Each year, the long-term care crisis worsens. More older adults require long-term care, the costs of providing that care are higher, and supply of direct care workers to meet care needs continues to shrink. Yet the main challenge to ease this crisis isn’t the lack of good ideas to reform it. Good ideas already exist. The main challenge to ease this crisis is the political will to address it.

Proposals to reform both public and private long-term care financing have emerged for decades. The new Interactive Compendium of Federal Long-Term Services and Supports (LTSS) Financing Policy Options offers an accessible look at all of them. This tool—created by the LeadingAge LTSS Center @UMass Boston and ATI Advisory, with support from The SCAN Foundation—allows users to search through nearly four decades of proposals that have been offered to ease the long-term care financing crisis.

“This lays out all the different proposals to reform long-term care financing, either on the public or private side or both. What are the great ideas that have already been laid out? What are their pros and cons?” asks Eileen Tell, a fellow with the Gerontology Institute at UMass Boston, who led the work to develop the tool. “Brilliant actuaries and researchers and academics in the field have already thought of these. We don’t have to start from scratch.”

Even as the long-term care financing situation has grown more complicated, many of the core challenges persist. That means that even proposals made years ago could be applicable and adaptable to this moment. These past proposals may inspire future change.

“This compendium allows people to go to a single place to learn about the ideas that have already been put forward and to learn how each differs from another. And it does so in a very accessible way,” says Marc Cohen, co-director of the LeadingAge LTSS Center @UMass Boston, who also developed the tool. “This builds the intellectual infrastructure for policy development.”

The compendium can aid the work of anyone who studies or works in long-term care financing reform: legislators, advocates, academics, and journalists. These users can search for previous long-term care financing proposals in multiple ways—for example, searching by the type of proposal, program structure, population served, and covered services—and then view the original source documents. The compendium includes proposals that address both federal and private programs.

“The problem is big enough for both kinds of reform, public and private,” Tell says. “Certainly, most everyone agrees that the private market could do much more than it’s doing now, but it could never do it all because there will always be people who don’t qualify or can’t afford private long-term care insurance.”

This compendium is the first of three interactive tools that the LTSS Center @UMass Boston is involved in developing with other collaborators. The second, a collaboration between the LTSS Center and the Milken Institute School of Public Health—which is currently in development—explores proposals that address family caregiver support. The third will address the direct care workforce. By creating the long-term care financing compendium first, they’ve created a framework that can be used for other issues as well. They hope their work reveals an array of thought that people have already invested into these challenges.

“The longer we take to address this problem, the bigger it’s going to get,” Tell says. “The goal is not only to come up with a technical solution, but to find the political will and common ground to choose a solution or to pick the best of several solutions and put them together.”

To share the significance of this tool, Cohen quoted Nobel Prize winner Milton Friedman: “Only a crisis, actual or perceived, produces real change. When that crisis occurs, the actions that are taken depend on the ideas that are lying around. That, I believe, is our basic function: to develop alternatives to existing policies, to keep them alive and available until the politically impossible becomes the politically inevitable.”

The long-term care financing crisis is already here, and some very good ideas are lying around. This new interactive compendium makes the latter accessible when the former is acknowledged.

If you have questions about the Interactive Compendium of Federal Long-Term Services and Supports Financing Policy Options, please contact Jennifer McGivney, director of communications for the Gerontology Institute at UMass Boston, to learn more.