Performance Improvement 2008. What Changes Were Observed Among Private Long-Term Care Insurance Claimants?


This study analyzed data from a longitudinal information collected from a sample of 1,400 individuals with long-term care (LTC) insurance, who notified their insurance company that they were receiving or intended for receipt of paid services for which they would file or had filed a claim under their LTC policy. These individuals comprised "an admissions cohort" of new LTC service users. This admissions cohort was tracked over a period of 16 months. This study compiled selected findings of data collected from the first four follow-up telephone interviews completed after the initial in-person baseline assessment. These interviews were conducted at four-month intervals and examined key issues related to changes in disability status, the use of care management services, individual experience with the claims filing process, and transitions through the continuum of care.

Claimants experienced high mortality rates, 11 percent died within four months of initiating service; 18 percent died within one year. Over the course of one year, roughly one-quarter of the sample exited the LTC system. There were low (2.4 percent) claims denial rates and low rates of disagreement with the insurance company for denials or other claims decisions (6 percent).

Report Title: Following an Admissions Cohort: Care Management, Claim Experience and Transitions among an Admissions Cohort of Privately Insured Disabled Elders over a 16 Month Period;
Agency Sponsor: ASPE-ODALTCP, Office of Disability, Aging, and Long-Term Care Policy
Federal Contact: Pamela Doty, 202-690-6443
Performer: Lifeplans
PIC ID: 8643

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"PerformanceImprovement2008.pdf" (pdf, 1.29Mb)

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