Long Term Care Insurance Plans (LTCIPs) can cover the costs of long-term senior living needs.
Price caps or price setting: States can limit insurance costs by setting price caps (limit the maximum providers charge for services before reimbursement) or price setting (establish a fixed price for a service to receive reimbursement). While the effects of health insurance price caps, setting, and growth rates on medical insurance costs are well studied, similar studies of these factors on LTCIPs are lacking.
Pegged or capped growth rate: States can also limit the rate at which insurance premiums grow by pegging cost increases to the rate of inflation or by capping the growth in costs to a fixed percent. This can ensure that lifetime maximum benefits keep up with the rising cost of care.
Related Science Note:
American Association for Long Term Care Insurance (2023) Group vs. Individual Long Term Care Insurance. https://www.aaltci.org/long-term-care-insurance/learning-center/group-long-term-care-insurance.php
Assistant Secretary for Planning and Evaluation (2021) Medical Device Supply Chains: An Overview and Description of Challenges During the COVID-19 Pandemic. 2023. https://aspe.hhs.gov/reports/medical-device-supply-chains
Baum, A, et al. (2019) Health Care Spending Slowed After Rhode Island Applied Affordability Standards To Commercial Insurers Health Affairs. 38 (2):237-245. https://www.healthaffairs.org/doi/abs/10.1377/hlthaff.2018.05164
Brookings (2022) The future Of WA Cares: A response to Warshawsky. https://www.brookings.edu/research/the-future-of-wa-cares-a-response-to-warshawsky/
California Department of Insurance (2014) Long Term Care Insurance. 2023. http://www.insurance.ca.gov/01-consumers/105-type/95-guides/05-health/01-ltc/ltc-insurance.cfm
Chernew, M, Pany, MJ (2021) Regulation of Health Care Prices: The Case for Backstop Price Caps in Commercial Health Care Markets JAMA. 325 (9):817-818. https://doi.org/10.1001/jama.2020.26821
Cossitt-Glesner, I (2021) Finding Long-Term Solutions for Long-Term Care. https://www.ncsl.org/research/health/finding-long-term-solutions-for-long-term-care.aspx
Cutler, D, Zeckhauser, RJ (1998) Adverse Selection in Health Insurance. National Bureau of Economic Research. https://www.nber.org/system/files/chapters/c9822/c9822.pdf
Jacobson, M, Earle, CC, Price, M, Newhouse, JP (2010) How Medicare’s Payment Cuts For Cancer Chemotherapy Drugs Changed Patterns Of Treatment Health Affairs. 29 (7):1391-1399. https://www.healthaffairs.org/doi/abs/10.1377/hlthaff.2009.0563
Johnson, R (2016) Who Is Covered by Private Long-Term Care Insurance? Urban Institute. https://www.urban.org/sites/default/files/publication/83146/2000881-Who-Is-Covered-by-Private-Long-Term-Care-Insurance.pdf
Kaiser Family Foundation (2021) Limiting Private Insurance Reimbursement to Medicare Rates Would Reduce Health Spending by About $350 Billion in 2021. https://www.kff.org/medicare/issue-brief/limiting-private-insurance-reimbursement-to-medicare-rates-would-reduce-health-spending-by-about-350-billion-in-2021/
Lin, H, Prince, JT (2016) Determinants of Private Long-Term Care Insurance Purchase in Response to the Partnership Program Health Service Research. 51 (2):687-703.
National Association of Insurance Commissioners (2016) The State of Long-Term Care Insurance: The Market, Challenges and Future Innovations. 2023. https://content.naic.org/sites/default/files/inline-files/cipr_current_study_160519_ltc_insurance.pdf
National Association of Insurance Commissioners (2019) CIPR Program: The State of Long-Term Care Insurance. https://content.naic.org/sites/default/files/inline-files/2019_CIPR_LTCI%20Brief.pdf
National Association of Insurance Commissioners. (2023) Long-Term Care Insurance. https://content.naic.org/cipr-topics/long-term-care-insurance
Oregon Office of the Secretary of State (2019) Hospital Payment Rules. 2023. https://www.oregon.gov/oha/OEBB/DivisionRules/Proposed-OEBB-OARs-Hospital-Payments.pdf
Schramm, S, Aters, Z (2021) Estimating the Impact of Reference-Based Hospital Pricing in the Montana State Employee Plan. National Academy for State Health Policy. https://www.nashp.org/wp-content/uploads/2021/04/MT-Eval-Analysis-Final-4-2-2021.pdf
Sen, A, et al. (2022) Participation, Pricing, and Enrollment in a Health Insurance “Public Option”: Evidence From Washington State's Cascade Care Program The Milbank Quarterly. 100 (1):190-217. https://onlinelibrary.wiley.com/doi/abs/10.1111/1468-0009.12546