CBO on Long Term Care

CBO released a great report on Long Term Care for the elderly (what is now most typically being called long term services and supports). Several key figures/graphs. The first shows that most people receiving LTC do not live in Nursing Homes, but in the community.

ScreenHunter_01 Jun. 27 17.18

A little over half of LTC care (in terms of its economic value) is provided by families and others on an informal, unpaid basis.

ScreenHunter_02 Jun. 27 17.20

So, when you see this break down of payments for LTC by type of payer, remember that over HALF of the total economic value of all LTC is not accounted for in the graph below, but is paid for implicitly by family members.

ScreenHunter_03 Jun. 27 17.24

Two quick policy take home points:

  • When evaluating a long term care proposal of any type, the correct cost to compare it with  is not zero; the default costs are huge, it is just that many of them accrue silently via informal care.
  • The lack of a coherent LTC system is causing problems in all sorts of other policy areas. Just two examples are in hospice policy, where long stays are likely driven at least in part by persons seeking care in a way that has turned hospice in some areas into a back door long term care benefit. Similarly, hospital re-admissions are at least partly driven by LTC break downs that are beyond the scope of any hospital-based program to address.

The hope for coherent policy making in this area is negligible in the near future.

About Don Taylor
Professor of Public Policy at Duke University (with appointments in Business, Nursing, Community and Family Medicine, and the Duke Clinical Research Institute). I am one of the founding faculty of the Margolis Center for Health Policy, and currently serve as Chair of Duke's University Priorities Committee (UPC). My research focuses on improving care for persons who are dying, and I am co-PI of a CMMI award in Community Based Palliative Care. I teach both undergrads and grad students at Duke. On twitter @donaldhtaylorjr

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out / Change )

Twitter picture

You are commenting using your Twitter account. Log Out / Change )

Facebook photo

You are commenting using your Facebook account. Log Out / Change )

Google+ photo

You are commenting using your Google+ account. Log Out / Change )

Connecting to %s

%d bloggers like this: