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New Report Outlines Challenges of Sustaining Long-Term Care in America
February 20, 2007

Contact: Lindsey Spindle
[email protected]

Washington, DC – With policymakers grappling with how to best prepare for the onslaught of aging Americans, Avalere Health today released a new report outlining the complexities of providing and paying for long-term care. The report provides healthcare decision-makers with a fact-based starting point to assess systematic reforms to the long-term care system.

Prepared for the non-partisan National Commission for Quality Long-Term Care, “Long-Term Care in America/An Introduction,” chronicles an array of evolving demographic, cultural, and financial issues that impact long-term care. The report reveals a generational shift away from nursing home care to varied community-based settings, the dominance of out-of-pocket spending and donated care in the financing system, and the lack of federal quality controls over many places that provide long-term care services.

Commission Co-Chair Bob Kerrey, the former senator from Nebraska and member of the 9/11 Commission, said reforms need to be made now before the system becomes unsustainable.

“This report is the starting point for us to explore new strategies for creating a world-class, sustainable long-term care system that simultaneously addresses human needs and financial realities. It is a tough debate, but inertia is simply not an option given current demographic and financial trends,” said Kerrey.

“More and more Americans are living in a house of cards when it comes to caring for their loved ones,” noted fellow Co-Chair Newt Gingrich, the former Speaker of the House. “We have a moral and economic imperative to address the sustainability of the long-term care system.”

The Commission, which is overseen by The New School in New York City, grew out of an industry-led quality initiative called Quality First, A Covenant for Healthy, Affordable, and Ethical Long-Term Care.  In 2004, the three leading industry organizations called for an independent commission to:

  • Evaluate the quality of long-term care in America;
  • Identify factors influencing the ability to improve quality; and
  • Recommend national strategies for sustainable quality improvement.

“Any assessment of long-term care spending must take into consideration the enormous sacrifice of families and friends who take time away from work and other responsibilities to care for loved ones,” said Anne Tumlinson, a long-term care expert at Avalere Health and lead author of the paper. “People who need long-term care often face high costs with no private insurance to pay for it.”
Notable facts from the Avalere report include:

  • Spending for long-term care in the U.S. totaled $185.3 billion in 2004 (the latest available year)
  • The share of the “very old” population aged 85 and over is expected to reach nearly 20% in 2040, from levels just above 10% in the year 2000
  • About 4.5 million people have Alzheimer’s disease, double 1980 levels
  • People aged 85 and older living in nursing homes declined from 21.1% in 1985 to 13.9% in 2004
  • Annual turnover rates for paraprofessionals in the long-term care field range from 42% to 100%
“Long-Term Care in America/An Introduction,” authored by Anne Tumlinson and Scott Woods of Avalere Health, is available for download here.