This Research Brief summarizes recent research on older adults' LTSS risks and financial resources that the Urban Institute completed for ASPE. Except where noted, the studies used data from the Health and Retirement Study, a large, nationally representative survey that has been tracking older Americans since 1992.
Long-Term Services & Supports, Long-Term Care
ASPE conducts research, analysis, and evaluation of policies related to the long-term care and personal assistance needs of people of all ages with chronic disabilities. ASPE’s work also highlights the financing, delivery, organization, and quality of long-term services and supports, including those supported or financed by private insurers, Medicaid, Medicare, and the Administration for Community Living (ACL). This includes assessing the interaction between health care, post-acute care, chronic care, long-term care, and supportive services needs of persons with disabilities across the age spectrum; determining service use and program participation patterns; and coordinating the development of long-term care data and policies that affect the characteristics, circumstances, and needs of people with long-term care needs, including older adults and people with disabilities.
Noteworthy
Most Older Adults Are Likely to Need and Use Long-Term Services and Supports
More than one-half of older adults, regardless of their lifetime earnings, are projected to experience serious LTSS needs and use some paid LTSS after turning 65.
Older adults with limited lifetime earnings are more likely to develop serious LTSS needs than those with more earnings.
However, fifty-six percent of older adults in the top lifetime earnings quintile receive some paid LTSS, and the likelihood of nursing home care does not vary much by lifetime earnings. Learn more.
Reports
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Assessing the Out-of-Pocket Affordability of Long-Term Services and Supports Research Brief
Loss of Medicare-Medicaid Dual Eligible Status: Frequency, Contributing Factors and Implications
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Analysis of Pathways to Dual Eligible Status: Final Report
Zhanlian Feng, PhD,Alison Vadnais, MHS, Emily Vreeland, BA, Susan Haber, PhD, Joshua Wiener, PhD, and Bob Baker, BA RTI International Printer Friendly Version in PDF Format (46 PDF pages)
ASPE Issue Brief
Transitions in Care and Service Use among Medicare Beneficiaries in Inpatient Psychiatric Facilities Issue Brief
Medicare beneficiaries in inpatient psychiatric facilities (IPFs) have complex conditions that require sustained engagement with physical and mental health care providers. People who receive care from IPFs are at risk for a range of negative health outcomes, but surprisingly little is known about their patterns of care.
Integrating Care through Dual Eligible Special Needs Plans (D-SNPs): Opportunities and Challenges
The 11 million individuals dually-eligible for Medicare and Medicaid are among the highest need populations in either program. However, a lack of coordination between the Medicare and Medicaid programs makes it difficult for individuals enrolled in both to navigate these fragmented systems of care and adds to the cost of both programs.
How Many Older Adults Can Afford To Purchase Home Care?
To estimate home much paid home could possibly be purchased out of income and wealth, we estimated the share of older adults with sufficient monthly income to cover median home care costs as well as other living expenses. Our results show that many older adults with severe LTSS needs could not afford 2 years of paid home care without financial assistance.
Patterns of Care and Home Health Utilization for Community-Admitted Medicare Patients
This study conducted exploratory analyses to develop a better understanding of community-admitted Medicare home health patients, including whether there have been any differential trends between community-admitted and post-acute care (PAC) patients over time and what their patterns of care tell us about the underlying reasons for the community-admitted increased numbers.
What Is the Lifetime Risk of Needing and Receiving Long-Term Services and Supports?
This brief provides new evidence on the lifetime risk that older adults will need LTSS and receive paid services and supports.
Primary and Behavioral Health Care Integration Program: Impacts on Health Care Utilization, Cost, and Quality
This report describes an extension of the RAND Corporation's evaluation of the Substance Abuse and Mental Health Services Administration's Primary and Behavioral Health Care Integration (PBHCI) grants program.
Report to Congress
Report to Congress: Current State of Technology-Enabled Collaborative Learning and Capacity Building Models
This report responds to the December 2016 “Expanding Capacity for Health Outcomes (ECHO) Act,” Public Law 114-270, which requires the Department to report to Congress on a range of issues related to technology-enabled collaborative learning and capacity building models and make recommendations on their use. This report consists of a summary document that includes the Department’s recommen