Avalere and The SCAN Foundation Unveil First-of-its-Kind Long-Term Care Analytic Tool

Web-based Interactive Model Allows Users to Design Long-Term Care Policies, Analyze Costs and Coverage

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Apr 15, 2010, 01:00 ET

WASHINGTON, April 15 /PRNewswire/ -- Avalere Health, in partnership with The SCAN Foundation, today released an innovative web-based modeling tool that enables policymakers and the public to test the budgetary implications of a wide variety of federally run long-term care insurance programs. The model, called the Long-Term Care Policy Simulator, produces more than 2,500 unique outputs, each illustrating how public long-term care insurance program designs and benefits translate into estimated coverage, participation rates, and costs to participants and taxpayers.

Release of this powerful tool immediately follows passage of the Patient Protection and Affordable Care Act, which includes a provision, Community Living Assistance Services and Supports (CLASS), that creates a new public long-term care insurance program. The Administration will make important decisions about where monthly premiums will be set, which will influence how many people are likely to participate. This tool can shed light on premium and participation implications of a CLASS-like benefit, as well as other types of benefit designs that policymakers might consider in building on the CLASS program foundation.

"Modeling long-term care policy options and their associated costs is increasingly important as the Administration moves forward with innovative long-term care policy options. This tool allows a new level of transparency and interactivity that will benefit consumers, policymakers, and others with a vested stake in improving long-term care," said Anne Tumlinson, a vice president of Avalere Health. "Users can step into policymakers' shoes to create long-term care policy and then see how their selections directly impact benefit design, individual and federal costs, and the potential popularity of the benefit. This knowledge will create broader understanding of a complex yet critical aspect of health reform."

The SCAN Foundation commissioned Avalere to create the Long-Term Care Policy Simulator to address an important information gap in the analytic underpinning of the long-term care debate. Outside of Congressional Budget Office and Office of the Actuary estimates of CLASS and certain Medicaid community-based care expansions, policymakers have had little opportunity to assess and compare the impact of other ideas and policy options.

Users can design their own program to see the immediate and long-term ramifications of pulling policy levers. Policy options that can vary using the tool are:

Participation: Mandatory or voluntary
Type of benefit: Cash or services
Eligibility: Individuals who are attached to the workforce or open to all persons
Vesting requirement before being able to receive benefits: Zero or five years
Benefit amount
- Daily rate for cash benefit: $50, $75, or $100
- Co-pay and deductible for service benefit: 20 percent co-pay and $500 deductible or no co-pay and deductible
Length of benefit: Lifetime, five years, four years, three years, or one year
Low-income subsidy: Persons under 150 percent of the federal poverty level (FPL), persons under 100 percent of the FPL, or no subsidy
Percentage of program funded through premiums: 100 percent, 75 percent, or 50 percent

After selecting each of the options, the user sees how a selected benefit design affects various policy considerations, such as average monthly premium amount, potential federal Medicaid savings, estimated enrollment in the program, and percent of people with disabilities covered by the program.

"The Long-Term Care Policy Simulator is a powerful educational tool designed to help people understand how a choice of policy options translate into long-term benefits and costs," said Bruce Chernof, MD, president and CEO of The SCAN Foundation. "The information provided by this model will not only illuminate decision points related to implementing the CLASS program but more importantly will also help policymakers and stakeholders think through long-term care policy options for the future."

This tool comes amid widening recognition of the enormous long-term care challenges facing the country, as well as the recent enactment of CLASS. Previous Avalere research on this topic shows that most people have not planned for their long-term care needs and are unaware of their options. As a result, private long-term care insurance has not been widely adopted by consumers. Other examples of Avalere's work in the long-term care arena – including work conducted with The SCAN Foundation and Georgetown University – can be seen here.

Access the Long-Term Care Policy Simulator at www.ltcpolicysimulator.org. Visit www.avalerehealth.net to learn about upcoming audio-conferences at Avalere, including a call about the Long-Term Care Policy Simulator.

The SCAN Foundation is an independent nonprofit foundation dedicated to advancing the development of a sustainable continuum of quality care for seniors that integrates medical treatment and human services in the settings most appropriate to their needs and with the greatest likelihood of a healthy, independent life. The SCAN Foundation supports programs that stimulate public engagement, develop realistic public policy and financing options, and disseminate promising care models and technologies. For more information about The SCAN Foundation, visit www.thescanfoundation.org.

Avalere Health is an advisory services company whose core purpose is to create innovative solutions to complex healthcare problems. Based in Washington DC, the firm delivers research, analysis, insight, and strategy for leaders in healthcare business and policy. Avalere's experts span 125 staff drawn from the federal government (e.g., CMS, OMB, CBO, and the Congress), Fortune 500 healthcare companies, top consultancies, and nonprofits. The firm offers deep substance in areas ranging from healthcare coverage and financing to the changing role of evidence in healthcare decision-making. Its focus on strategy is supported by a rigorous, in-house analytic research group that uses public and private data to generate quantitative insight. Through events, publications, and interactive programs, Avalere also translates real-time healthcare developments into actionable information. Learn more at www.avalerehealth.net.

SOURCE Avalere Health