Description: A proposal to reform the health care provider payment system through: a national fee schedule, shifting more reimbursements to primary care providers, better integration of hospital & physician fees, evidence based care, pay for performance, and a better provider risk sharing mechanism.

Description: This article from major US payers describes palliative care as a scaleable means of improving quality and reducing costs during serious and complex illness.

Description: A proposal to address provider payment issues by gradually moving to accountable care organizations. Capitations would be risk-adjusted, non-capitated costs would be covered by hospitalization fund and stoploss, incentives for quality & effective preventive care would be tied to the amount remaining in the fund, and government involvement would be through incentives rather than mandate.

Description: For a long time the primary focus of private LTC insurance companies has been to educate the public about the need for private LTC insurance and to make the product more acceptable to a wider population. To this end there have been numerous changes to the product design to make this product more acceptable to general population. However, one of the things that may have been overlooked in those product design changes is the need for alignment of policyholder and insurance company’s interests, which is to make coverage more affordable and to reduce adverse selection. Incentivizing good behavior from policyholders can not only make LTC insurance policies less expensive but also help policyholders make better health choices, which can help them stay healthy for a longer time. These incentives may also reduce some of the inherent risks in a long term care policy and may help in increasing the sales of private LTC insurance.

Description: This article defines LTC insurance and looks at the advantages large employers have to gain from group LTC. From Long-Term Care News, March 2006, Issue No. 17.

Description: Results of the survey conducted just prior to the 2015 ILTCI Conference.

Description: Using Healthcare Claims Data to Create Actuarial Models.

Description: Rhode Island’s unique “global Medicaid waiver” pursues a potentially dangerous national policy trend: long-term care LTC rebalancing without strong eligibility controls. Resulting cost overruns could seriously damage the state’s social safety net. To maximize the global waiver’s opportunity, minimize its danger, and become a LTC financing model for the country, policy makers need to recognize the issues discussed in this report and pursue the recommended additional research and analysis.

Description: Medical management programs have traditionally addressed more acute and short-term issues with chronic disease. As LTC becomes an important product in the insurance industry, including disease management is likely to be valuable for reducing costs and prolonging the healthy, premium-paying portion of a claimant's life.

Description: This article is based on a third party administrator study and explores the relationships between family structure, spare capacity and health care utilization.