'Self-reliance' a key to long-term care financing reform, experts say

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The United States is likely to favor an approach to long-term care financing reform that values self-reliance but includes some form of social safety net, according to a new report from a panel of experts. 

The Finance Review Task Force was convened by LeadingAge, one of the nation's largest long-term care provider associations, after the Affordable Care Act's LTC component was scrapped. The 20-member group included leaders from research groups and think tanks, provider companies and the LeadingAge staff and board.

The group identified seven pathways to LTSS finance reform and described potential advantages and pitfalls of each approach in its report. It based its analysis in part on a study of LTSS finance systems in other countries and found that the United States spends a comparable amount of public dollars on long-term care, even though the country has no formalized “system” for meeting people's needs in this arena.

However, even though 70% of long-term care currently is paid for through public programs, it is not likely that LTSS reform proposals will succeed if they do not emphasize the importance of self-reliance and personal responsibility. This is because successful policy innovation is shaped to a large extent by “cultural values and expectations,” the report states.

The work of the task force was a first step in what LeadingAge says will be an ongoing initiative to foster a “national discussion” on this issue. Through mid-2015, it will build coalitions at the local, state and national levels and use “engagement methodologies” to promote progress.

The report was approved by the LeadingAge board at the association's recent annual meeting in Dallas.