Filed Under:Health Insurance, Ltci

Alzheimer's Draft Authors Mention LTCI - Briefly

Federal Alzheimer's disease policymakers aren't giving much thought to the idea that private long-term care insurance (LTCI) providers could play a role in helping consumers cope with the condition.

The authors of the new draft National Plan to Address Alzheimer's Disease mention the role of private LTCI coverage only in passing.

The National Alzheimer's Project Act of 2011 (NAPA) requires U.S. Health and Human Services (HHS) Secretary Kathleen Sebelius to work with a new Advisory Council on Alzheime'rs Research, Care and Services to create a national plan for overcoming Alzheimer's disease.

Sebelius also is supposed to coordinate Alzheimer’s disease research and services across all federal agencies and accelerate the development of treatments that would prevent, halt, or reverse the course of Alzheimer’s disease.

National plan drafters note that they are using the term "Alzheimer's disease" to refer to a wide range of what are now thought of as being irreversible brain orders, including Alzheimer's disease and dementias associated with frontotemporal problems, vascular problems or Lewy bodies.

The dementia-causing conditions included in the term "Alzheimer's disease" affect a total of about 5.1 million U.S. residents, and the number affected seems likely to increase as the average age of the U.S. population increases, the drafters say.

The drafters note that dementia-causing conditions place a terrible strain on family caregivers and others who provide home care, and that about half of nursing home residents have dementia. They estimate providing nursing home care for a resident with dementia costs an average of about $78,000 per year.

The Obama administration recently announced the National Institutes of Health will increase funding for Alzheimer's research by $50 million. The administration's 2013 budget proposal calls for providing another $80 million for Alzheimer's research.

The "National Plan" project associated with the draft plan is supposed to get $26 million for consumer Alzheimer's disease education, provider education, caregiver support programs, and Alzheimer's disease data collection efforts.

The draft National Plan lists actions the federal government can take immediately, actions the government and private partners can take soon; and long-range efforts.

"This is a National Plan and not a federal plan," the plan drafters note. "It will require the active engagement of public and private sector stakeholders to achieve."

One of the three guiding principles for the plan is that plan implementers should "optimize existing resources and improve and coordinate ongoing activities," and a second is that implementers should "transform the way we approach Alzheimer's disease."

A third is tht implementers should "support public-private partnerships."

"The scope of the problem of Alzheimer’s disease is so great that partnerships with a multitude of stakeholders will be essential to making progress," the plan drafters say. "The plan looks to the Advisory Council in particular to identify key areas where public-private partnerships can improve outcomes."

The plan drafters talk about taking steps such as increasing enrollment in clinical trials, expanding studies that might identify Alzheimer's risk factors, and encouraging more professionals to enter fields related to geriatric specialties.

The National Plan drafters put in some kind words for the Patient Protection and Affordable Care Act of 2010 (PPACA).

The drafters suggest that, in some cases, the inability to get health care due to a lack of insurance is a major concern. "This is particularly important for individuals with younger-onset disease who may not yet be eligible for Medicare," the drafters say. "Much of that insecurity will be alleviated as the Affordable Care Act, with its elimination of pre-existing conditions limitations and expansion of insurance coverage, is implemented."

The drafters refer to private LTCI coverage only in a section on helping families prepare for planning for future care needs.

"The vast majority of people do not think about or plan for the long-term services and supports they will need until they experience a disability or AD," the drafters say. "Many Americans incorrectly believe that Medicare will cover most of the costs of these supportive services. Unfortunately, by the time care is needed, it is difficult to get coverage in the private long-term care insurance market, and options are limited.Educating people about their potential need for long-term services and supports and the significant advantages of planning ahead for these services encourages timely preparation. Planning ahead can help ensure that individuals with AD receive care in the setting they prefer and that their dignity is maintained."

Under the "helping families plan" heading, plan drafters suggest that HHS should find out why middle-aged adults fail to plan for long-term care (LTC) needs. The drafters suggest that HHS also should expand LTC awareness efforts.

Comments on the draft are due March 30.

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