“Securing the Future,” a quite comprehensive report issued by the Massachusetts Long-Term Care Financing Advisory Committee earlier this year, has had little or no press so far. The committee, made up of leaders in the fields of health insurance, long-term care, politics and services for people with disabilities (but no elder law attorneys) takes a clear-eyed look at how we pay for long-term services and supports (LTSS) in Massachusetts now and how the costs will bust the bank in the future if we do not make changes soon.
If we make no changes, the committee foresees LTSS costs increasing by 50 percent to $28 billion per year 20 years from now. Of this amount, without changes, 38 percent of the costs will be borne through out-of-pocket expenses, unpaid caregivers and unmet need, with state government paying 21 percent.
With the changes the committee recommends phasing in over the next 10 years, the commonwealth’s costs will decrease by $1 billion a year and the portion of costs to be covered by individuals when they need care will decrease from 38 to 15 percent.
These changes would be accomplished through a combination of the encouragement of the use of prefunding through long-term care and the CLASS Act and expansion of MassHealth to permit broader eligibility for community-based services to avoid more expensive institutionalization. In addition, the plan would provide greater assistance to unpaid caregivers in order to avoid “burn out” and avoid forcing them to make impossible choices between, for instance, caring for a family member and keeping a job.
So far, this 70-page set of recommendations on how Massachusetts can move from its current uncoordinated system of LTSS to an integrated, more cost-effective approach has received little or no publicity. Perhaps after we get through the current budget cycle and summer vacations, it will reach a larger audience.