Making Sense of the Election:

The President and the Congress and Where We Go from Here 

Speakers: Joel White and Bob Blancato

Topic:

Reprising their 2020 presentation, these two political experts will explore the outcomes of the November elections including Congressional Committee and Administration staffing.  What might this all mean for aging and long term care policy in the coming year?  Based on prior years, this session is always informative, lively, insightful, and entertaining.  We are pleased to have two experts who can speak so knowledgeably about what we might see. 

About the Speakers:

Joel White

Joel is the Founder and President of Horizon Government Affairs, a health care consultancy that represents several dozen clients and runs four coalitions comprised of 200 organizations dedicated to reforms that improve our health system. Horizon has specific issue expertise in drug pricing, coverage and reimbursement; technology and data issues; and insurance and benefit design matters. Horizon has helped enact more than 50 laws since its founding and prevented countless bad ideas from seeing the light of day.

Previously, Joel spent twelve years on Capitol Hill including as Staff Director of the Ways and Means Health Subcommittee. While on the Hill he helped enact nine laws, including the:

• 2002 Trade Act, which created health care tax credits for private coverage;

• 2003 law that established the Medicare prescription drug benefit and created Health Savings Accounts; and

• 2005 Deficit Reduction Act and the 2006 Tax Reform and Health Care Act, which reformed Medicare payment policies.

Joel also runs a charitable organization that seeks to end poverty and is on the boards of several non-profits in the patient advocacy space. He holds a B.S. in Economics from the American University and is the co-author of the book, Facts and Figures on Government Finance.

Bob Blancato 

Bob is the President of Matz, Blancato and Associates. In that capacity, he also serves as the National Coordinator of the bipartisan 3000-member Elder Justice Coalition, the Executive Director of the National Association of Nutrition and Aging Services Programs and National Coordinator of the Defeat Malnutrition Today coalition.   

Bob has long been recognized as a national advocate with policy expertise on behalf of older adults. In 2019, he was invited by both the Senate Finance Committee and House Ways and Means Committee to testify on a range of issues.

Bob’s prior work history includes 17 years as a staffer in Congress and an appointment by President Clinton to be the Executive Director of the 1995 White House Conference on Aging, one of four he has participated in.  He is a member of the Senior Executive Service.

As a volunteer, he currently serves on the National Board of AARP and the board of the National Hispanic Council on Aging. In 2019, Bob began a four-year term on the National Advisory Committee on Rural Health and Human Services, appointed by HHS Secretary Azar.

Bob holds a BA from Georgetown University and an MPA from American University. Bob has won numerous awards for advocacy, most recently the American Society for Aging’s ASA Hall of Fame Award in March 2020.

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Speaker: Jonathan Westin, ACL

ABOUT THE TOPIC:

Almost two years to the day after the 2022 delivery of the National Strategy to Support Family Caregivers to Congress and the nation, the Family Caregiving Advisory Council and the Advisory Council to Support Grandparents Raising Grandchildren, with support from the Administration for Community Living, released their 2024 Update Report to Congress. The report, entitled “Federal Implementation of the 2022 National Strategy to Support Family Caregivers,” highlights the federal government’s progress in implementing its nearly 350 commitments  intended to better recognize and support family caregivers across numerous program and initiative areas. 

This session will provide an overview of the 2024 Update Report and showcase some of the key accomplishments reported by the federal government. The presentation will highlight the momentum across federal agencies and the work currently under way to support implementation of the Strategy, particularly within ACL.

ABOUT THE SPEAKER:

Jonathan S. Westin, MPA

Jonathan Westin is an Aging Services Program Specialist with the Department of Health & Human Services’ Administration for Community Living (ACL), Office of Supportive and Caregiver Services. Over the past two decades, Jon has developed a strong track record in the long-term services and supports policy arena as a reliable source for the non-profit sector, government officials, and thought leaders on aging services delivery and financing reform.

Before joining ACL, Jon delivered strategic guidance to networks of health and aging providers and has worked with appointed and elected officials on pragmatic ways to improve the nation’s health and aging delivery systems.

Jon received his Bachelor of Arts in Political Science and his Master of Public Administration from American University in Washington, DC. For over a decade, he has been a member of the National Academy of Social Insurance which comprises the nation’s leading professionals on programs such as Medicare, Medicaid, and Social Security. Jon is also the past Chair of the Partnership for Medicaid, a prominent national coalition focused on improving the nation’s largest health insurance program.

Jon lives in the Washington, DC area with his wife and two children.

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More details to follow:

When: Nov 7, 2024 02:00 PM Eastern Time (US and Canada)

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Speakers: Juliet Spector and Jeff Anderson 

ABOUT THE TOPIC:

With the goals of improving sustainability of long-term care insurance (LTC) blocks of business, implementing fewer rate increases, and greater product innovation, the private sector LTC insurance market has increased its attention on LTC wellness and aging-in-place programs. These programs are broad and vary, but all share the overall goals of improving health outcomes, reducing the severity of future claims, and reducing overall LTC costs. Although the idea of wellness is not new in healthcare, LTC carriers and vendors have been intensely focused on it in the last few years, as proven wellness strategies that work in healthcare have shown promise in optimizing the use of scarce and costly healthcare resources.

It is important for stakeholders to understand the components of LTC wellness arrangements, as well as the practical issues and impediments that contribute to success or failure. Many in the LTC market believe increased knowledge sharing, technological improvements, and identifying best practices can continue to increase the success of LTC wellness plan initiatives and the overall health and wellness of LTC policyholders.

Our speakers will discuss the key themes critical to program success and the important considerations for designing, evaluating risk, and measuring the results of LTC wellness programs. As stakeholders become more skilled at managing the practical details of LTC wellness and enhance their infrastructures to collect and process meaningful quality and savings metrics for their target populations, defining the key features that hinder or support the success of LTC wellness programs will become easier. In doing so, providers and stakeholders will refine and implement more sophisticated models to better manage LTC paid claims and policyholder experience.

A link to the August 6 report can be found here Long-term care wellness initiatives: Key components of building and evaluating a sustainable program (milliman.com)

ABOUT THE SPEAKERS:

Juliet Spector is a Principal and Consulting Actuary at Milliman. She offers expertise and guidance to both providers and insurers in understanding and estimating the complex financial risks associated with healthcare and long-term care costs. She has extensive experience with long-term care insurance including expert witness work, cash flow testing, mergers and acquisitions, financial reporting and reserve development, administrative conversion, first principles modeling, stochastic modeling, state insurance department rate filings, experience analysis, product development, pricing, and international work. She is a Product Manager for Milliman’s LTC Advanced Risk Analytics (LARA) product. Her combined experience in value-based care and long-term care gives her a unique perspective in the LTC Wellness space. And allows her to leverage learnings from ACOs and wellness vendors in other healthcare spaces to LTC. She is the editor of the Milliman LTC Newsletter, served on the SOA LTC Section Council, and edited the LTC Section Council Newsletter.

 Jeff Anderson is a Principal and Consulting Actuary at Milliman. He has worked to support clients through various aspects of long-term care insurance since 2009. He has extensive experience in experience analysis, assumption development, and first principles modeling. He has also supported clients in mergers and acquisitions, pricing, state insurance department rate filings, valuation, asset adequacy testing, and financial reporting. He is a Product Manager for Milliman’s LTC Advanced Risk Analytics (LARA) product and has supported multiple insurance carriers as they develop, implement, and evaluation long-term care wellness and aging-in-place programs.

ACCESSING THE MEETING:  The registration link for the meeting is   https://us02web.zoom.us/meeting/register/tZ0tdeCsqzovHtbB1ui3TIOpOmBjrWEL6_7L 

About the topic:

Is price the best way to determine the value of different long term care (LTC) insurance benefits? In this webinar, Milliman will present an alternative metric: LTC Actuarial Value (LTC AV), which can indicate the amount of coverage a plan provides without the complexities and challenges of comparing prices and financing approaches. To put it another way, LTC Actuarial Value (LTC AV) is an alternative metric to a plan’s price. The calculation of the LTC AV is independent of the plan’s price, instead using expected benefit costs to illustrate the amount of coverage an insurance plan provides.

The speakers will explain the concept of LTC AV, discuss potential applications in benefit evaluation and design, and issues around consumer education. They will provide an update on upcoming LTC AV research and tool development.

About the speakers:

Chris Giese is a Principal and Consulting Actuary at Milliman. Chris has management and actuarial consulting experience with healthcare and long-term care (LTC) programs, with more than 20 years of experience in these areas. He has assisted various entities, including insurance companies, health plans, employers, technology firms, and government programs. He has helped clients with a wide variety of projects, such as financial projections and reporting, valuation of reserves, experience analysis, product development and pricing, appraisals, risk management, and evaluations of financing reform alternatives. Chris is currently serving on the Society of Actuaries (SOA) Social Insurance and Public Finance Section Council and previously served as Chair of the SOA LTC Section Council. Chris has also participated in various SOA and American Academy of Actuaries work groups.

Annie Gunnlaugsson is a Consulting Actuary at Milliman. Annie’s work focuses on long-term care, where she has more than 10 years of experience. She has worked with state government agencies to perform feasibility and actuarial studies as they explore and implement public long-term care financing solutions. Additionally, she has helped clients with year-end statements of actuarial opinion, state insurance department LTC rate filings, and reserve estimation for medical and long-term care products.

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Helping People Identify and Plan for Their Future Long Term Care Needs:

Using Data Science to Predict Individual Long Term Care Needs and identify Solutions

________________________________________

Speakers: Evan Ehrenberg and Lily Vittayarukskul, Waterlilly

 ABOUT THE TOPIC:

The complexities of long-term care (LTC) and retirement planning pose significant challenges for both individuals and professionals. As life expectancies increase and economic conditions change, understanding the risks and costs associated with aging becomes crucial. Tools used today which include national averages, zip code calculators, and Monte Carlo simulations, are woefully inadequate for charting an individual’s care path.  That’s due to the complex array of factors that play into whether and how much LTC someone might need – e.g.,   health condition, family situation and risk preferences, gender, age, other demographics, family history, lifestyle, and more. 

This talk will discuss how data science is being used to develop a planning tool designed to help individuals visualize their own future care needs and explore how various financial protection options might meet those needs.  This tool is intended to help consumers (and financial planners and others) address the educational barriers in conveying the importance of LTC planning.   The tool – called Waterlily - uses 500 million datapoints of demographic and healthcare data to predict individuals’ future LTC needs and costs and presents a range of care options and financial solutions. Details will be provided regarding the tool’s development, testing phases, and its current applications in enhancing LTC planning and awareness.

ABOUT THE SPEAKERS:

Evan Ehrenberg is Waterlily’s COO and Co-Founder, previously founded and served as CEO of Clara Health and UpperBoundAI. Before his entrepreneurial journey, Evan attended college when he was 11, graduating from UC Berkeley with his bachelor's degree in Cognitive Science and Computational Modeling when he was 16. He then went on to pursue his Ph.D. at MIT in Computational Neuroscience where he used machine learning and computer vision modeling to advance computational neuroscience and AI research. Evan dropped out of his Ph.D. just before defending his thesis when he was 21 to scale Clara Health as it took off.

Lily Vittayarukskul is Founder and CEO at Waterlilly, where she oversees the development of the interactive predictive tool that is designed to help prepare families for their future LTC needs, addressing LTC costs faced by families, state governments, and insurance carriers. Waterlilly does this using predictive AI (artificial intelligence) to create a personalized projection of an individual’s future care needs, and then guiding them and their family through building out logistics and financial plans for their care.  Prior to that, she worked at a telemedicine startup from 2019 to 2021, involved in product development, AI prototype building, successful product launches, and scaling of an IoT AI telemedicine platform. Lily also led business efforts to launch the company's first product, developed market positioning, strategy, and sales training. Prior to that, she was a Data Scientist Consultant at STELLARES. Lily also held roles as Head of Technology and Head of Growth and Development at Research to the People. Additionally, she worked as a Scientist Intern (Software Developer) at DNAnexus, and had an internship at NASA Jet Propulsion Laboratory in 2013. Lily earned a Bachelor of Arts degree in Genetics and data science from the University of California, Berkeley.

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Thursday, March 28, 2024

3:00 - 4:00 pm

Eastern Time

Improving Home and Community-Based Services (HCBS) Access and Outcomes

for Dual-Eligible Beneficiaries of Color

Speakers: Michael Brand, Marc Cohen, and Carrie Fisher

ABOUT THE TOPIC:

Community Catalyst and the LeadingAge LTSS Center @UMass Boston, with support from Arnold Ventures, explored whether the home and community-based services (HCBS) system is prepared to meet the needs of aging dually eligible beneficiaries of color.  This is a population disproportionately impacted by poverty, greater levels of unmet needs and often the most complex health statuses due to racism, classism, and other forms of oppression.  

The project was guided by two questions:  What disparities in access to HCBS exist for dually eligible beneficiaries of color?  How can we mitigate the disparities through policy change?   The research components included a literature review, key informant interviews, consumer focus groups, a community listening session, and data analysis using the Health and Retirement Study (HRS).

The speakers will discuss general trends in HCBS usage and unmet needs among dually eligible beneficiaries, disparities in access and utilization of HCBS services among beneficiaries of color, and the impact and importance of a usual source of care in getting needs met. They will also discuss policy recommendations to address disparities and the research processes that generated them. 

ABOUT THE SPEAKERS:

About the Speakers:

Mike Brand, MSW, is a Policy Analyst for the Center for Community Engagement in Health Innovation at Community Catalyst. In this role, Mike works to advance equitable and community-centered policies across issue areas including dual eligibility, caregiving, home and community-based services, community benefit and economic stability.

Mike worked for over a decade supporting people, families, and communities from a variety of populations to get their behavioral health needs met. Mike also assisted medical students in developing person-centered care practices as a teaching associate for the Department of Medical Sciences at Brown University. Prior to his current role, Mike served as an MSW intern and a program associate at Community Catalyst.

Mike received a bachelor’s degree in psychology from the University of Massachusetts Amherst and a Master in Social Work (MSW) from Rhode Island College. He also earned a certificate of graduate studies in non-profit leadership and development from Rhode Island College.

Marc A. Cohen, PhD is co-director of the LeadingAge LTSS Center @UMass Boston.  He is a professor of gerontology at the University of Massachusetts and research director at Community Catalyst.  Prior to joining UMass Boston, he was chief research and development officer, former president, and co-founder of LifePlans, Inc., a long term care research and risk management company.  During his 30-year career, Marc has led major research studies related to issues affecting financing and delivery of long-term services and supports, led a national demonstration of a new falls-prevention program sponsored by the U.S. Department of Health and Human Services, and work with managed care plans implementing new models of care designed to reduce hospital readmissions.  He received an MA from the Kennedy School of Government at Harvard University, and a PhD from the Heller School at Brandeis University.

Carolyn (Carrie) Fisher is a Research and Evaluation Scientist at the Institute for Community Health (ICH), where she leads evaluation and applied research projects with a focus on health-related advocacy and policy, trauma and trauma-informed approaches to evaluation, qualitative methods, and equitable evaluation. She has lectured and led workshops and webinars on community engagement, trauma-
informed approaches, and qualitative methods for a wide range of audiences. Carrie earned her PhD in Cultural Anthropology from the Graduate Center of the City University of New York (CUNY).

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Wednesday, February 28, 2024

1:00 - 2:00 pm

Eastern Time

Evaluations of Managed Long Term Services and Supports (MLTSS)

and Integrated Care “Dual Demo” Programs:

Key Findings and Implications for Federal and State Policy

Speakers: Debra Lipson and Danielle Chelminsky

ABOUT THE TOPIC:

About half of all states contract with Medicaid managed care plans to deliver long-term services and supports – managed LTSS or MLTSS programs -- a sizable increase over the last two decades.  Ten states, some of which also operate MLTSS programs, participated in the federal Financial Alignment Initiative (FAI) demonstration, which contracted with managed care plans to provide integrated Medicare and Medicaid benefits and coordinated services for dually eligible individuals.

What does the evidence show about the effects of MLTSS and FAI integrated care demonstrations on access, cost, quality and beneficiary experience? In this session, researchers will summarize major findings from recent evaluations of these programs and discuss implications for federal and state policy. 

The session will also discuss what the future may hold. How many more states are likely to switch from Medicaid fee-for-service to MLTSS?  What are the FAI demonstration states planning to do to promote integrated Medicare and Medicaid LTSS programs after the FAI initiative ends in 2025?  What lessons can states learn from the FAI demonstrations as they further integration of Medicare and Medicaid through other platforms? What are CMS, MACPAC and other federal agencies planning to do to maximize the benefits, and minimize the risks, of these programs to Medicaid and dually eligible beneficiaries?

ABOUT THE SPEAKERS:

Debra Lipson, M.H.S.A., is a Senior Fellow at Mathematica. Over her 35 years as a health policy researcher, she has conducted numerous research and evaluations of Medicaid managed care, LTSS initiatives for older adults and people with disabilities, and integrated care for dually eligible individuals. In the last 10 years, she directed several large CMS-funded projects, including one that provided technical assistance to federal and state officials to strengthen their oversight of Medicaid managed care and MLTSS plans, and another that developed and tested two dozen new Medicaid quality measures, including the first set of nationally standardized measures for MLTSS and HCBS.

Danielle Chelminsky, M.P.H, is a Researcher at Mathematica, who directs and plays key roles in several research and technical assistance projects focused on the design and operation of Medicare-Medicaid integration programs for dually eligible individuals.  She currently directs a project for CMS’ Medicare-Medicaid Coordination Office that conducts research on beneficiary experiences with FAI demonstration integrated care programs and was deputy director of the Integrated Care Resource Center (https://www.integratedcareresourcecenter.com), which provides technical assistance to states seeking to advance integrated care for dually eligible individuals. 

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Wednesday, January 31, 2024

2:00 - 3:00 pm

Eastern Time

Public Policy for Long Term Care

Speaker: Mark J. Warshawsky 

ABOUT THE TOPIC:

The speaker will present his perspectives on the following topic: “Long term care (LTC) in the United States is financed by a mix of private and, mainly, public funds. With the current and projected aging of the population, it is not fiscally sustainable. The system—especially public insurance—is also unfair, riddled with bad incentives and poorly administered and is getting worse. Yet the existing structure, including private insurance, can be improved and the situation rectified by a few key changes, as outlined in this session.”

ABOUT THE SPEAKER:

Mark J. Warshawsky is a senior fellow at the American Enterprise Institute (AEI), where he focuses on Social Security and retirement issues, pensions, long-term care, disability insurance, and the federal budget.

Before joining AEI, Dr. Warshawsky served as deputy commissioner for retirement and disability policy at the Social Security Administration. Earlier he served as a member of the Social Security Advisory Board, vice chairman of the federal Commission on Long-Term Care, and assistant secretary for economic policy at the US Department of the Treasury, where he had a key role in the development of the Pension Protection Act of 2006. He has also held senior positions at Towers Watson, the Federal Reserve Board, the IRS, and the TIAA-CREF Institute.

Dr. Warshawsky was also a senior research fellow at George Mason University’s Mercatus Center, a visiting scholar at the MIT Golub Center for Finance and Policy, and president of ReLIAS, a firm specializing in customized retirement income strategies. He is the architect of the life care annuity, a product integrating the immediate life annuity and long-term care insurance benefits.

Dr. Warshawsky has testified often before Congress. He is the author, coauthor, or coeditor of eight books, including Retirement Income: Risks and Strategies (MIT Press, 2011) and the ninth edition of Fundamentals of Private Pensions (Oxford University Press, 2010).  His work has appeared in the American Economic Review, the Quarterly Journal of Economics, Health Affairs, the Journal of Financial Planning, the Journal of Retirement, the Journal of Risk and Insurance, Tax Notes, RealClearPolicy, RealClearMarkets, the Hill, and the Wall Street Journal, among other outlets.

He has a PhD in economics from Harvard University and a BA in economics from Northwestern University.

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Wednesday, December 20, 2023

2:00 - 3:00 pm

Eastern Time

Own Your Future 3.0: Reports Examine New Directions for LTSS in Minnesota

Speakers: Nikki Peterson, Steve Schoonveld, and John O’Leary

ABOUT THE TOPIC:

Minnesota has consistently ranked first or second among all 50 states in the AARP LTSS scorecard. Most recently, in 2023, it was named #1 again. However, two new studies commissioned by the Minnesota Department of Human Services, as part of the state’s continued interest in the Own Your Future (OYF) effort, raise a number of issues about the future need for and costs of LTSS for Minnesota’s aging population going forward. A demographic study of Minnesota’s 65 plus population, provides a detailed look at Minnesota’s older adult population and projects dramatic growth in LTSS usage and costs for Minnesota’s Medicaid population by the year 2035.

A second study, “Options to Increase Access to Long-Term Care Financing, Services, and Supports in Minnesota” found that, even with Minnesota’s success in LTSS, there are still service gaps, particularly for Minnesota’s middle income population, that will be exacerbated as the population ages. That study discusses three innovative funding approaches the state can consider to address these issues going forward.

The link to the LTSS Financing Study is here… https://mn.gov/dhs/assets/OYF-LTSS-funding-services-initiative_tcm1053-600470.pdf

When it is posted, the demographic study will be found on the OYF reports page at https://mn.gov/dhs/ownyourfuture/reports/

ABOUT THE SPEAKERS:

Nikki Peterson is the Quality Assurance and Improvement Planner for the Minnesota Department of Human Services, Aging and Adult Services Division. She recently assumed leadership of the Own Your Future Initiative which aims to make Minnesotans more aware of their need to plan for Long Term Care and helps develop more affordable and suitable financial options that can help them pay for it.

Steve Schoonveld is an actuary and Managing Director with FTI Consulting. Steve brings over 30 years of experience in the Long-Term Care and Health Care industries serving clients across the long-term care and public policy spectrum. On this project he assisted the Minnesota Department of Human Services as the principal consultant and led the engagement across the three firms, FTI Consulting, Altarum Institute and The Actuarial Research Corporation.

John O’Leary is President of O’Leary Management Associates LLC, a consulting practice dedicated to helping organizations plan, develop, and implement strategic, product, and market solutions for the Aging market. John has worked extensively with the Minnesota on various aspects of Own Your Future since 2014, most recently as external project manager/consultant on Own Your Future 3.0. He also recently co-authored (with John Cutler) a report for the Society of Actuaries entitled “Long-Term Care Coverage: Stakeholder Thoughts on State-Based Catastrophic Insurance.”

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LTC

Thursday, November 30, 2023

2:00 - 3:00 pm

Eastern Time

AARP's 2023 LTSS State Scorecard:

Data Insights to Advance a High-Performing, Equitable LTSS System

Speakers: Carrie Blakeway Amero & Ari Houser

 ABOUT THE TOPIC:

ABOUT THE TOPIC:

The LTSS State Scorecard compares state LTSS systems across multiple dimensions of performance, reflecting the importance and interconnectedness each has on the overall LTSS system. This fifth edition of the Scorecard, released in September 2023, seeks to raise the profile of LTSS and drive action both federally and within states by measuring state LTSS system performance using 50 indicators across 5 dimensions, and ranking states in comparison to one another on each measure.

Released every three years, the Scorecard is a compilation of state data and analysis based on a new vision of a high-performing state long-term services and supports (LTSS) system.  It uses data from a wide range of sources to describe how state LTSS systems are performing, relying on indicators that have been tracked as far back as the first Scorecard in 2011 to show trends over time. It also includes 20 new indicators and new ways of analyzing and displaying data to provide a more comprehensive picture of state performance. 

This presentation will discuss key findings, including effects of the COVID-19 pandemic (all data are from 2020 and later), a focus on innovation, the new dimension of community integration, and incorporating equity in LTSS performance using data broken down by race and ethnicity wherever possible.

ABOUT THE SPEAKERS:

Carrie Blakeway Amero is director, Long Term Services and Supports (LTSS) at the AARP Public Policy Institute. She provides guidance, oversight and support for AARP’s LTSS-related strategic initiatives, collaborates with AARP partners, and coordinates the ongoing work of the LTSS Choices initiative, a multi-year, multi-faceted project to catalyze the transformation and modernization of the nation’s long-term care system into one that meets the dynamic needs and preferences of consumers and their families. Before joining AARP, Amero was a managing consultant at The Lewin Group for 17 years where she supported several clients including the Administration for Community Living, the CMS Disabled and Elderly Health Programs Group (DEHPG), and the Center for Medicare and Medicaid Innovation (CMMI). She has extensive experience providing technical assistance to states, community-based organizations, health care providers, and LTSS providers and supporting continuous quality improvement through learning systems. She earned a master’s in public affairs from the LBJ School of Public Affairs at the University of Texas at Austin and a bachelor’s degree in anthropology also from the University of Texas at Austin.

Ari Houser is a senior methods advisor at the AARP Public Policy Institute, where he has been the lead data analyst on several major recurring and stand-alone projects, including the Nursing Home COVID-19 Dashboard and the Long-Term Services and Supports State Scorecard. In addition, he provides methodological and statistical assistance across the Public Policy Institute on other topics. Before joining AARP, Houser worked at the RAND Corporation and taught classes in statistics and public policy. He earned his Ph.D. in measurement, statistics, and evaluation from the University of Maryland and also has bachelor’s degrees in engineering and physics from Swarthmore College.

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Meeting ID: 889 7391 0939

Wednesday, October 25, 2023

2:00 - 3:00 pm

Eastern Time

Advancing the National Strategy to Support Family Caregivers:

Updates and Activities

Speakers: Greg Link, Wendy Fox-Grage, Pamela Nadash, and Eileen Tell

 ABOUT THE TOPIC:

The 2022 National Strategy to Support Family Caregivers was created to support family caregivers of all ages, from youth to grandparents, regardless of where they live or what caregiving looks like for them and their loved ones. The strategy was developed jointly by the advisory councils created by the RAISE Family Caregiving Act and the Supporting Grandparents Raising Grandchildren Act, with extensive input from the public, including family caregivers, the people they support and the organizations and providers that serve family caregivers. In 2023, the Councils were re-constituted with new members, and a charge of moving the Strategy forward.

The National Strategy is meant to evolve and be responsive to prevailing needs and issues arising from the caregiving landscape; the aim is to update it on a biennial basis. This presentation will describe the focus of current efforts to implement and update the Strategy: Greg Link will report on the range of federal actions that have been put into motion, while Wendy Fox-Grage will describe the role of the National Academy for State Health Policy in advancing and supporting state-level actions. Eileen Tell and Pamela Nadash will report on the public’s reactions to the National Strategy, as indicated by a request for Public Comments that was promulgated from October to December 2022. 

ABOUT THE SPEAKERS:

Wendy Fox-Grage

Wendy Fox-Grage is a senior policy fellow on NASHP's Aging and Disability team, working on long-term services and supports, family caregiving, and palliative care. She joined NASHP in September 2019. Previously, she worked as a senior strategic policy advisor for the AARP Public Policy Institute for 15 years and as a program principal for the National Conference of State Legislatures for nearly 10 years. She started her career as a Congressional Fellow for the U.S. Senate Special Committee on Aging. She has a BS in human development and social policy from Northwestern University and Master’s degrees in both gerontology and public administration from the University of Southern California.

Greg T. Link 

With more than 30 years of experience in aging and family caregiver support programs, Greg oversees ACL’s efforts to implement a range of federally-supported programs and initiatives. His office has responsibility for the National Family Caregiver Support Program, ACL’s dementia program portfolio, the Lifespan Respite Program and other initiatives including the Eldercare Locator, Community Care Corps and person-centered, trauma-informed supportive services for Holocaust survivors and other older adults and family caregivers with histories of trauma. Greg holds a bachelor’s degree in psychology from the University of Central Florida and a master’s degree in government from the Johns Hopkins University.

Pamela Nadash

Pamela Nadash, PhD, BPhil, is an Associate Professor in Gerontology at the University of Massachusetts Boston whose work centers on policies that enable people with needs for long term services and supports (LTSS) to receive needed supports.  This includes looking cross-nationally at different countries’ long term care financing and service delivery systems, as well as studying variations in policies and practices among states in the US. Her history of working with state LTSS systems extends back to her seat on the management team of the Cash and Counseling Demonstration and Evaluation (1995-98); she has been deputy director of three Robert Wood Johnson Foundation National Program Offices (as well as a team member for a fourth), supporting research and pilot programs for a variety of LTSS programs, as well as conducting associated research. More recently, she has been working to support the RAISE Family Caregiver Advisory. Council Her work has been published widely in peer-reviewed scientific journals.

Eileen J. Tell

Eileen J.  Tell is Principal and Owner of ET Consulting, a woman-owned consulting firm specializing in long term care and aging, and a Fellow of the Gerontology Institute at the University of Massachusetts Boston. She engages in policy analysis, stakeholder and consumer research (qualitative and quantitative), program and materials development, consumer and professional education, literature review and other analytic work. Her clients have included the U.S. Department of Health and Human Services, States of Minnesota, Washington and Illinois, National Academy of Social Insurance (NASI), Long Term Care Partners, Truven Health Analytics, National Council on Aging (NCOA) Services, University of Massachusetts/ Boston’s McCormack Gerontology Center, Torchlight Eldercare, Intervene Rx, and LTCG.

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Thursday, August 24, 2023

2:00 - 3:00 pm

Eastern Time

Out of the Woodwork? Medicaid Home and Community-based Services Spending for Older Adults

Speakers: Brian McGarry and David Grabowski

 ABOUT THE TOPIC:

Although older adults prefer to age at home, Medicaid has a longstanding institutional bias in funding long-term services and supports (LTSS). Some states have resisted expanding Medicaid funding for home- and community-based services (HCBS) due to budgetary concerns related to the so-called “woodwork” effect whereby individuals enroll on Medicaid to access HCBS.

To examine the implications associated with state Medicaid HCBS expansion, the authors compared outcomes in states that expanded Medicaid HCBS aggressively versus those that expanded less aggressively. They explored a range of outcomes including Medicaid enrollment, nursing home census, Medicaid institutional LTSS spending, total Medicaid LTSS spending, and Medicaid HCBS waiver enrollment.

The authors found that HCBS expansion was not associated with increased Medicaid enrollment – the so-called woodwork effect -- among individuals ages 65 and older. Increased HCBS waiver spending was associated with more older adults receiving LTSS at a lower cost per beneficiary served relative to the nursing home setting.  Moreover, these states experienced Medicaid savings from reduced nursing home use, suggesting states that expand Medicaid HCBS are able to use these additional dollars to serve more LTSS recipients.

Their article can be found here:

https://agsjournals.onlinelibrary.wiley.com/doi/epdf/10.1111/jgs.18478

ABOUT THE SPEAKERS:

Brian E McGarry, PT, PhD 

Brian McGarry is an assistant professor in Medicine at the University of Rochester Medical School.  He is a physical therapist and health services researcher with an interest in the economics of aging. His research focuses on older adults' navigation of the Medicare program and long-term care system, as well as the impact of public policies on the cost and quality of care delivered to older adults. He completed his PhD in Health Services Research at the University of Rochester School of Medicine and Dentistry and a postdoctoral fellowship in Health Economics and Policy at Harvard Medical School.

David C Grabowski, PhD

David Grabowski is a professor of health care policy in the Department of Health Care Policy at Harvard Medical School. His research examines the economics of aging with a particular interest in the areas of long-term care and post-acute care.  He has published over 220 peer-reviewed articles. From 2017 through 2023, Dr. Grabowski was a member of the Medicare Payment Advisory Commission (MedPAC). He has also served on several CMS technical expert panels.  Grabowski received his BA from Duke University and his PhD in public policy from the Irving B. Harris School of Public Policy at the University of Chicago.  

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Tuesday, May 30, 2023

2:00 - 3:00 pm

Eastern Time

Establishing a California Long Term Care Social Insurance Program

Speaker: Stephanie Moench, Principal, Oliver Wyman

 ABOUT THE TOPIC:

This session will provide an overview of California’s progress in developing a statewide insurance program for long-term care services and supports. In 2019, AB 567 established a Long Term Care Insurance Task Force (Task Force) with oversight by the California Department of Insurance. The Task Force’s mandate is to assess the feasibility of developing and implementing a culturally competent statewide insurance program for long-term care services and supports in California. Oliver Wyman was retained by the California Department of Insurance in 2021 to support the Task Force’s work. In December 2022, the Task Force unanimously approved the Feasibility Report, which summarizes their recommendations and outlines financial, administrative, and political feasibility considerations. This session will provide an overview of the Feasibility Report along with an update on next steps in California. A copy of the report is available here.

SPEAKER:

Stephanie Moench is a Principal with the Actuarial Practice of Oliver Wyman and co-leads the LTC Practice. She has over 12 years of experience in LTC consulting, specializing in actuarial modeling, assumption development, and model governance. Stephanie has expertise in both traditional LTC and combination LTC products and has worked with a wide range of clients in the areas of pricing, valuation, assumption development, in-force management, wellness, litigation, reinsurance, and risk. Prior to joining Oliver Wyman, Stephanie was a Consulting Actuary at Milliman, where she worked for 10 years. Stephanie is currently part of the Oliver Wyman team supporting the state of California in exploring the feasibility of implementing a statewide LTC insurance program for its residents.

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Thursday, April 27, 2023

2:00 - 3:00 pm

Eastern Time

How COVID has Changed Long Term Care Insurance

Speaker: Sandy Jones, Partner, Faegre Drinker

 ABOUT THE TOPIC:

Although the masks are for the most part behind us, the residual impacts and effects of COVID-19 will be felt by all for many years to come. In this interactive session, Sandy Jones will discuss some of the considerations for long-term care insurance companies that have been caused by, exacerbated by, or are attendant to the COVID-19 Pandemic.

This discussion will include a holistic review of how the long-term care insurance industry has been impacted in almost every way. Specific examples and risks will be addressed ranging from claims and policy administration practices, company hiring and staffing/retention, company-wide consistency issues, country-wide care shortages, accommodations, policy and claims exceptions, and increasing experience with fraud, waste and abuse. 

Sandy will also discuss the legal risks and pitfalls surrounding each of these issues. The session will also touch upon recent litigation matters that have been filed that directly relate to the Pandemic and its lasting impact.

About the Speaker:

Sandy Jones is a partner at Faegre Drinker in its Philadelphia office. Sandy has nearly two decades of long-term care insurance experience and co-leads the firm’s 30+ lawyer long-term care insurance team, which is the largest team of long-term care insurance focused attorneys in the U.S.  Sandy and her colleagues have experience in all areas of long-term care insurance and have a true “soup-to-nuts” practice. The team at Faegre Drinker has addressed nearly every issue facing the industry today, including underwriting, claims, pricing and rate increases, wellness, fraud, technology, AI, solvency, liquidation, sales, marketing, and product development.

Sandy has assisted her industry clients with building and developing new long-term care insurance and combination products, advising on complex claims and rate issues, providing regulatory guidance, and avoiding market conduct exams.  She has also litigated and successfully resolved more long-term care insurance litigation matters than nearly any attorney in the U.S. 

Sandy also leads the firm’s Structured Settlement and Annuity Team and is a nationally-recognized attorney in that space. She lives in Wayne, Pennsylvania with her husband, two daughters, and pets.

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Tuesday, May 30, 2023

2:00 - 3:00 pm

Eastern Time

Initiatives to End Social Isolation and Loneliness and its Associated Negative Health Impacts

Speakers: Eddie Garcia, Abby Gadbois and Jillian Racoosin

 ABOUT THE TOPIC:

Established in the Fall 2018 and based in Washington, D.C., the Coalition to End Social Isolation & Loneliness brings together dozens of national organizations including consumer groups, community-based organizations, health plans, mental and behavioral health organizations, health care innovators, and many others to lead a multi-stakeholder dialogue to address the crisis of social isolation and loneliness in America. The Coalition focuses on three major areas to achieve this goal:

·       Disseminating research findings

·       Developing and advocating for federal and state legislative and regulatory policy interventions and

·       Leading public awareness events in Washington, D.C. and across the nation.

The COVID-19 pandemic has greatly accelerated efforts to engage Congress and the Executive Branch on a range of federal policy priorities, including leveraging and advancing social services and supports, supporting health care delivery to support those who are socially isolated and/or lonely, and advancing federally-funded research initiatives.

Our speakers will discuss efforts at the global, national and community level to address concerns with social isolation, loneliness and building connections – all of which are critical to the health and well-being of older adults.  They will discuss the work of the Coalition, as well as the Harvard National Action Forum which brings together thought leaders and change-makers from across the globe for the End Social Isolation and Loneliness Action Forum.

About the Speakers:

JSPEAKERS:

Jillian Racoosin is the Executive Director of the Foundation for Social Connection and the Coalition to End Social Isolation and Loneliness. In her role, Jillian is responsible for leading the direction of the Coalition and the Foundation’s operations and programs, including advancing social connection research and innovation. Previously, Jillian spearheaded enterprise go-to-market strategy for Force Therapeutics, a leading healthcare technology company, and care management platform.

Eddie Garcia is a Partner at Healthsperien. He brings thoughtful and expansive expertise in health and social policy development and advocacy for low-income and other vulnerable populations. Eddie’s 20 years working in government health and social services programs has made him knowledgeable in a multitude policy issue areas. Eddie serves as the lead Partner supporting Healthsperien’s health plan portfolio and as well as our coalitions and non-profits focused on social isolation and loneliness and mental health. In addition, he brings a wealth of knowledge and passion for policy and program development to expand access to social determinants of health and health equity programs and services.

Abby Gadbois is a policy analyst at Coalition to End Social Isolation and Loneliness and Healthsperien. Prior to joining Healthsperien, Abby worked at the Maryland Department of Health Behavioral Health Administration, Developmental Disabilities Administration and Medicaid Office of Long-Term Services and Supports. Abby conducted policy analyses, wrote position papers and testimony for MDH leadership, and managed policy initiatives and stakeholder outreach and workgroups for the administrations. Additionally, during the COVID-19 pandemic, Abby joined several special projects to provide infection control support to congregate care facilities and expand access to COVID-19 therapeutics.

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Thursday, March 30, 2023

2:00 - 3:00 pm

Eastern Time

 Exploring Stakeholder Perspectives on State-based Catastrophic Long Term Care Coverage

Speakers: John Cutler and John O’Leary

 ABOUT THE TOPIC:

The Society of Actuaries (SOA) Research Institute’s Aging and Retirement Strategic Research Program sponsored this exploration of stakeholder views on the feasibility and efficacy of a public catastrophic LTC insurance program at the state level. Minnesota was chosen because of its background as a state proactive in addressing aging and long term care issues. Based in part on prior work on federal catastrophic, including research by Marc Cohen, Judy Feder, Melissa Favreault, the Long-Term Care Financing Collaborative and others, this is the first phase of a study to explore stakeholder perspectives on catastrophic (backend) coverage at the state level. To do this, the authors defined two theoretical designs and then solicited feedback from a variety of Minnesota stakeholders. 

Highlights of the research include:

• Broad support for the concept and acknowledgement of its challenges

• Concerns about the feasibility of a tax increase to finance such a program

• Recognition of the value of properly interfacing a social insurance program with both Medicaid LTC coverage and private LTC insurance

The report can be accessed here:

https://www.soa.org/49301b/globalassets/assets/files/resources/research-report/2023/ltc-catastrophic-report.pdf

About the Speakers 

John Cutler, Esq. Over the last 30 years, John Cutler has specialized in Medicare, long term care insurance, aging policy and insurance benefit design. Since his retirement from the federal government in 2015, he has maintained a consulting business. His clients include the Society of Actuaries (SOA), exploring catastrophic public long term care insurance coverage. as well as the Minnesota Department of Human Services, looking at how to add home care benefits to Medicare as supplemental coverage.

Previous positions include the US Office of Personnel Management (OPM) where he was the architect and Project Leader for the Federal Long Term Care Insurance Program. John joined the federal government in 1997 as a Health Policy Analyst in the Office of the Assistant Secretary for Planning and Evaluation (ASPE) at HHS. Prior to that, he worked at AARP, with responsibility for regulatory and compliance matters involving AARP's insurance products. John has a BA from the University of Virginia and a law degree from the University of Georgia.

John O’Leary, MBA. John is President of O’Leary Management Associates LLC, a consulting practice dedicated to helping organizations plan, develop, and implement strategic, product, and market solutions for the aging market.  John’s career in long-term care includes senior marketing and product development positions at Genworth Financial, CNA Financial, and John Hancock. He is a recognized expert on the topics of long-term care and long-term care financing. He consulted on and authored the Society of Actuaries (SOA) Long-Term Care Think Tank Research Study entitled “Land this Plane.” John has consulted with the State of Minnesota on their Own Your Future Long-Term Care reform initiative since 2014. His other clients have included the Society of Actuaries, Philips Lifeline, The Harvard Medical School, LeadingAge and the SEIU labor organization. In addition, he worked on the Technical Advisory Panel for an economic modeling project on long-term care financing conducted by Milliman and the Urban Institute. John was co-chair of the SOA Long-Term Care Think Tank from 2014 to 2020, where he was an integral contributor to a landmark consumer research study funded by the Society of Actuaries. From 2015 through 2020, John was also co-chair of the Alternate Solutions Track and co-chair of the Aging in Place track in 2021 for the Intercompany Long-Term Care Insurance Conference. He was one of three co-chairs for the LTC Tech Summit held in November 2019 in Sunnyvale California.  John has an MBA from the Harvard Business School and a BA in Political Science from Northeastern University.

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Monday, February 6, 2023

2:00 - 3:00 pm

Eastern Time

 Update and Learnings from Washington State: 

What it means For the Future of Publicly Financed Long-Term Care Programs

Ben Veghte, Director WA Cares Fund  

 ABOUT THE TOPIC:

The nation’s first state-based universal long-term care insurance program, the WA Cares Fund, begins collecting premiums this July and can begin paying benefits in 2026. The program has been fine-tuned in significant ways since its enactment in 2019. What enhancements have been made?  What has the state learned about best practices for program design and administration? What has the state learned about potential public-private partnership? What issues remain to be addressed?

About the Speaker 

Benjamin W. Veghte is Director of the WA Cares Fund, the state’s new universal long term care program. He is an MIT CoLab Fellow, a Care Guild innovator, and an incoming member of the Board of Trustees of the American Society on Aging. Ben has three decades of experience researching and designing social insurance programs, with a focus over the past decade on care policy. He has a Ph.D. from the University of Chicago and an MPA from the Harvard Kennedy School of Government.TO ACCESS THE MEETING:

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Monday, January 30, 2023

1:00 - 2:00 pm

Eastern Time

 What Might Secure 2.0 Mean for LTC…and what is the future for state LTC legislative proposals

Speaker:

Howard Gleckman

Senior Fellow at The Urban Institute

 ABOUT THE TOPIC:

Secure 2.0 is largely focused on expanding opportunities for employee participation in retirement savings plans and making it easier for employers to offer those plans. Will a renewed focus on saving for retirement raise awareness of the importance of saving for LTC needs?  Will Section 334 that allows penalty-free withdrawal from retirement savings (but not tax-free withdrawal) encourage “on the fence” individuals to purchase LTC insurance?  Will new incentives boost demand for deferred annuity QLAC products? What are the latest rumblings on state-based public long-term care insurance? What other political forces and legislative trends should we be watching?

This session will explore these issues and more.

About the Speaker:

Howard Gleckman is a senior fellow at the Urban Institute, where he is affiliated with the Tax Policy Center and the Program on Retirement Policy. He writes regular columns on both aging policy and tax policy for Forbes.com.  

Before joining Urban, Gleckman was senior correspondent in the Washington bureau of Business Week, where he was a 2003 National Magazine Award finalist. He was a 2006–07 media fellow at the Kaiser Family Foundation and a visiting fellow at the Center for Retirement Research at Boston College from 2006 to 2008. He is author of the book Caring for Our Parents and speaks and writes frequently on long-term care issues.

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Thursday December 8, 2022

12:00 - 1:00 pm

Eastern Time

 Making Sense of the Mid-Term Elections: Where We Go from Here

Speakers:

Bob Blancato

Executive Director of the National Association of Nutrition and Aging Services Programs.

President of Matz, Blancato and Associates,

Joel White

Founder and President of Horizon Government Affairs,

 ABOUT THE TOPIC:

Every recent election seems to be dramatic. 2022 lived up to this in part because the expectations of a “red wave” were no truer than the blue one two years ago. This session of the LTC Discussion Group will explore the outcomes of the November elections including Congressional committee assignments, and any potential Administration changes. What might this all mean for aging and long term care policy in the coming year? We are pleased to have two experts who can speak knowledgeably and with insight and humor about what we might see.

About the Speakers:

Bob Blancato 

Robert “Bob” Blancato is the Executive Director of the National Association of Nutrition and Aging Services Programs. He is also President of Matz, Blancato and Associates, the National Coordinator of the bipartisan 3000-member Elder Justice Coalition, and the National Coordinator of the Defeat Malnutrition Today coalition. 

Bob has long been recognized as a national advocate with policy expertise on behalf of older adults. In 2019, he was invited by both the Senate Finance Committee and House Ways and Means Committee to testify on a range of issues.

Bob’s prior work history includes 17 years as a staffer in Congress and an appointment by President Clinton to be the Executive Director of the 1995 White House Conference on Aging, one of four he has participated in. He is a member of the Senior Executive Service.

As a volunteer, he currently serves on the National Board of AARP and the board of the National Hispanic Council on Aging. In 2019, Bob began a four-year term on the National Advisory Committee on Rural Health and Human Services, appointed by HHS Secretary Azar.

Bob holds a BA from Georgetown University and an MPA from American University. Bob has won numerous awards for advocacy, most recently the American Society for Aging’s ASA Hall of Fame Award awarded in April 2021.

Joel White

Joel White the Founder and President of Horizon Government Affairs, a health care consultancy that represents two dozen clients and runs four coalitions comprised of 200 organizations dedicated to reforms that improve our health system. Since Horizon’s founding in 2007, his team has helped enact more than 50 laws and helped shape countless regulations governing all aspects of the U.S. health care system.

Joel is the President of the Council for Affordable Health Coverage and its campaigns on transparency and medication adherence. He is also the Executive Director of the Health Innovation Alliance, an HGA effort to expand adoption and use of data and technology to make health care work better.

Previously, Joel spent twelve years on Capitol Hill including as Staff Director of the Ways and Means Health Subcommittee. While on the Hill he helped enact nine laws, including the 2002 Trade Act, which created health care tax credits for private coverage, the 2003 law that established the Medicare prescription drug benefit and Health Savings Accounts, the 2005 Deficit Reduction Act and the 2006 Tax Reform and Health Care Act, which reformed Medicare payment policies.. He holds a BS in Economics from the American University and is a member of the National Economist’s Club.

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October 12, 2022

3:00 - 4:00 pm

Eastern Time

 The 2022 National Strategy to Support Family Caregivers

Speakers:

Speakers:

Greg Link

Director, Office of Supportive and Caregiver Services

Administration on Aging

Administration for Community Living

Pamela Nadash, PhD,

Associate Professor in Gerontology at the University of Massachusetts Boston

Salom Teshale, PhD.

Policy Associate, National Academy for State Health Policy (NASHP)

 ABOUT THE TOPIC:

The 2022 National Strategy to Support Family Caregivers was created to support family caregivers of all ages, from youth to grandparents, regardless of where they live or what caregiving looks like for them and their loved ones. The strategy was developed jointly by the advisory councils created by the RAISE  Family Caregiving  Act and the Supporting Grandparents Raising Grandchildren Act, with extensive input from the public, including family caregivers, the people they support and the organizations and providers that serve family caregivers. The National Strategy will be updated in response to public comments and will evolve with the caregiving landscape.

The 2022 national strategy to support family caregivers is a whole-of-society approach to assist family caregivers.  This historic effort by the federal government provides an important roadmap to all those working to increase recognition for the critical role of family caregivers in our healthcare system and for those seeking policies and strategies to support them.  The strategy strengthens support for family caregivers by committing to more than 300 actions across 15 Federal agencies.  It also includes actions for states, employers and community-based organizations to consider.  The strategy is meant to be flexible and will be revised and evolved on a biennial basis.

This session will describe the development process for the National Strategy and the public comment and implementation process, and present key components and recommendations.

About the Speakers:

Greg T. Link.  With more than 30 years of experience in aging and family caregiver support programs, Greg oversees ACL’s efforts to implement a range of federally-supported programs and initiatives. His office has responsibility for the National Family Caregiver Support Program, ACL’s dementia program portfolio, the Lifespan Respite Program and other initiatives including the Eldercare Locator, Community Care Corps and person-centered, trauma-informed supportive services for Holocaust survivors and other older adults and family caregivers with histories of trauma. Greg holds a bachelor’s degree in psychology from the University of Central Florida and a master’s degree in government from the Johns Hopkins University.

Pamela Nadash, PhD, is an Associate Professor in Gerontology at the University of Massachusetts Boston whose work centers on policies that enable people with needs for long term services and supports (LTSS) to receive needed supports.  This includes looking cross-nationally at different countries’ long term care financing and service delivery systems, as well as studying variations in policies and practices among states in the US. Her history of working with state LTSS systems extends back to her seat on the management team of the Cash and Counseling Demonstration and Evaluation (1995-98); she has been deputy director of three Robert Wood Johnson Foundation National Program Offices (as well as a team member for a fourth), supporting research and pilot programs for a variety of LTSS programs, as well as conducting associated research. Her recent international work has included studies on both France and Germany’s LTSS systems and a book chapter on international trends in LTSS financing.  Her work has been published widely in peer review scientific journals. 

Salom Teshale, PhD is a Policy Associate on the National Academy for State Health Policy (NASHP)’s Behavioral Health, Aging, and Disability team.  She works on projects related to family caregiving and palliative care. Prior to joining NASHP, Salom was a postdoctoral fellow at the Administration for Community Living in the US Department of Health and Human Services and the University of Washington School of Medicine, where she conducted research on topics related to aging and well-being in adults aging with long-term disability, and participated in the Health and Aging Policy Fellowship (2018-2019). She holds a PhD from Brandeis University in social/developmental psychology, and a BA in psychology from the University of Chicago.

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July 20, 2022

2:00-3:00 PM

Eastern Time

 Reducing Avoidable Hospitalizations Among Nursing Home Residents:

Findings from an Evaluation of the CMS Initiative*

Speakers:

Galina Khatutsky, Lawren Bercaw, Micah Segelman, and Zhanlian Feng

 ABOUT THE TOPIC:

Every year, about 25% of people who live in nursing facilities are transferred to hospitals for acute care.  Avoiding unnecessary hospitalizations of nursing facility residents can improve resident health, increase quality of care, and reduce health care costs. While some of these transfers are required to treat specific health conditions or complications, many may be avoided through timely diagnosis and treatment within the nursing facility.

RTI evaluated a Centers for Medicare & Medicaid Services (CMS) Initiative to improve nursing facility resident health, increase care quality, and lower Medicare expenditures by reducing the number of avoidable hospitalizations. Using a mixed methods research design, the team collected and analyzed data to determine the CMS Initiative’s effects on hospital utilization, Medicare expenditures, and care quality. 

Two phases were evaluated. The first phase (2012-2016) evaluated the value of providing on-site clinical support for nursing facilities, which are generally understaffed and struggle with staff recruitment and retention. The second phase of the Initiative added a Medicare payment component (2016-2020) to incentivize participating nursing facilities and practitioners to provide on-site acute care for eligible long-stay residents. 

The session will discuss the research design and findings from this comprehensive and important evaluation.

*Initiative to Reduce Avoidable Hospitalizations among Nursing Facility Residents (NFI) - https://www.cms.gov/Medicare-Medicaid-Coordination/Medicare-and-Medicaid-Coordination/Medicare-Medicaid-Coordination-Office/InitiativetoReduceAvoidableHospitalizations/AvoidableHospitalizationsamongNursingFacilityResidents

About the Speakers:

Galina Khatutsky, MS, is a senior policy analyst in the Aging, Disability, and Long-Term Care Program at RTI International and was a co-project director for the evaluation. In her research, she has focused on studying home- and community-based systems of care, nursing facilities, long-term services and supports financing, dually eligible Medicare beneficiaries, long-term care workforce, and access to and utilization of health services.  

Micah Segelman, Ph.D., is a senior health policy researcher in RTI’s Center for the Health of Populations and was an associate project director for the evaluation. He has extensive experience in utilizing health services research methods to inform policy, particularly in the areas of long-term care and care for the elderly. Dr. Segelman has expertise in quantitative methods, including developing risk-adjusted quality measures and designing and conducting evaluations of policy interventions. He has extensive experience with Medicare data, Medicaid data, and the Nursing Home Minimum Data Set (MDS).

Lawren Bercaw, Ph.D., is a senior researcher within RTI’s Center for the Health of Populations and was an associate project director for the evaluation. Her areas of research include home- and community-based services, social determinants of health, and health equity for vulnerable populations. Dr. Bercaw’s qualitative research and leadership experiences include conducting more than 1,000 in-person and telephone interviews, leading focus groups, and coordinating technical expert panels with older adults, families, caregivers, physicians, nursing facility staff, and others who support diverse populations of older adults.

Zhanlian Feng, Ph.D., is a senior researcher in the Aging, Disability, and Long-Term Care Program at RTI International and was a co-project director for the evaluation. He studies long-term care access, quality, and costs. He is an expert in the use of large-scale administrative data sets, including Medicare and Medicaid claims, to address policy-relevant issues and uses sophisticated econometric analysis in quantitative evaluation approaches.

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Wednesday, June 15, 2022

1:00-2:00 PM Eastern Time

Building a Consistent National Approach for Reviewing

Long-Term Care Insurance (LTCI) Premium Rates

Speakers:

Fred Andersen & Ray Nelson

 ABOUT THE TOPIC:

Recognizing the pricing challenges that the current LTCI environment poses, both to consumers and for the state-based system of insurance regulation, the National Association of Insurance Commissioners (NAIC) formed a Long-Term Care Insurance (EX) Task Force. The mission of this Task Force is to: 1) develop and implement a coordinated national approach for reviewing LTCI rate increases; 2) monitor and evaluate the rate review process; 3) evaluate and recommend options to help consumers manage the impact of rate increases; and 4) monitor work performed by other NAIC groups to review the financial solvency of long term care (LTC) insurers.

The goal of developing a consistent national approach for reviewing current LTCI rates is expected to result in actuarially appropriate increases being granted by the states in a timely manner and the elimination of cross-state rate subsidization. To work towards these goals, the Task Force developed a multi-state actuarial (MSA) LTCI rate review process (MSA Review). This framework aims to create a voluntary and efficient MSA Review that produces reliable and nationally consistent rate recommendations that state insurance regulators and insurers can depend upon. The MSA Review has been designed to leverage the limited LTCI actuarial expertise among state insurance departments by combining that expertise into a single review process and producing an MSA Advisory Report for the benefit and use of all state insurance departments.

The goal of this framework is to create a process that will not only encourage insurers to submit their LTCI rate increase filings for multi-state review, but also to provide insurance departments with confidence in the MSA Review so they will voluntarily utilize the MSA Rate Review Team’s recommendations when conducting their own state level reviews of in force LTCI rate increase filings. The presenters will discuss the formation of the Task Force, its accomplishments to date, and next steps to foster as much consistency as possible across states in their approaches to LTCI rate increases.

About the Speakers:

Fred Andersen serves as Chief Life Actuary of the Minnesota Department of Commerce. Besides reviewing financial models related to the reserves and capital of Minnesota’s life insurers, he leads activities in innovation, consumer protection, and market efficiency at the National Association of Insurance Commissioners in areas involving long-term care insurance, indexed life & annuity products, variable annuities, and experience data reporting. Before joining the Department in June 2014, he served as Assistant Chief Life Actuary for the Insurance Division of the New York Department of Financial Services.

Ray Nelson is Senior Vice President, Actuarial Services of TriPlus Services, Inc.  Ray leads the team which provides comprehensive actuarial consulting services to various LTC clients including rate increase activities, modeling and projections, valuation, reporting, experience analysis, pricing and product management. He also provides actuarial consulting services to AHIP on various Health and LTC initiatives. Ray has more than 30 years of experience in LTCI, having previously worked at Bankers Life & Casualty Company, where he was responsible for pricing, product development, and product line management of the company’s LTCI offerings for 19 years. Ray is a member of both the Society of Actuaries and the American Academy of Actuaries.

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Integrated Care for Dually Eligible Beneficiaries and Medicaid HCBS Rebalancing:

An Update from MACPAC

Kirstin Blom, MIPA, Contracting officer and a principal analyst, MACPAC and Asmaa Albaroudi, MSG, senior analyst, MACPAC.

About the Speakers:

Kirstin Blom, MIPA, is the contracting officer and a principal analyst. Before

joining MACPAC, Ms. Blom was an analyst in health care financing at the

Congressional Research Service. Before that, Ms. Blom worked as a principal

analyst at the Congressional Budget Office, where she estimated the cost of

proposed legislation on the Medicaid program. Ms. Blom has also been an

analyst for the Medicaid program in Wisconsin and for the U.S. Government

Accountability Office (GAO). She holds a master of international public

affairs from the University of Wisconsin, Madison, and a bachelor of arts in

international studies and Spanish from the University of Wisconsin.

Asmaa Albaroudi, MSG, is a senior analyst. Prior to joining MACPAC, she

was a Health and Aging Policy Fellow with the House Energy and Commerce

Committee’s Subcommittee on Health. Ms. Albaroudi also worked as the

manager of quality and policy initiatives at the National PACE Association,

where she provided research and analysis on federal and state regulations. She

is currently a doctoral candidate at the University of Maryland-College Park’s

School of Public Health, where her research centers on long term care. Ms.

Albaroudi holds a master of science in gerontology and a bachelor of science in

human development and aging from the University of Southern California.

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Integrated Care for Dually Eligible Beneficiaries and Medicaid HCBS Rebalancing:

An Update from MACPAC

Kirstin Blom, MIPA, Contracting officer and a principal analyst, MACPAC and Asmaa Albaroudi, MSG, senior analyst, MACPAC.

 ABOUT THE TOPIC:

Integrated Care for Duals.  Over the past several years, the Medicaid and CHIP Payment and Access Commission (MACPAC) has engaged in many conversations regarding integrated care programs for individuals who are dually eligible for Medicaid and Medicare. Their work has focused on three goals: increasing enrollment in integrated products; making integrated products more widely available; and promoting greater care integration within existing products.

Our presenters will share highlights from the draft chapter of the June 2022 Report to Congress with a recommendation to require all states to develop a strategy to integrate coverage. They will also share high-level MACPAC comments on the Medicare Advantage proposed rule (finalized on May 9th) which includes many provisions affecting integrated care for the dually eligible, including a plan to transition Medicare-Medicaid plans to Medicare Advantage dual eligible special needs plans.   They will also discuss initial thoughts on the beneficiary experience in integrated care and ways of improving integration for dually eligible beneficiaries in fee-for-service states.

Workforce Shortages.  Over the last two decades, federal and state policymakers have focused on rebalancing long-term services and supports (LTSS) away from institutional settings and toward home and community-based services (HCBS). The COVID-19 pandemic has accelerated federal and state interest in promoting the use of HCBS over institutional services, but has also exacerbated the workforce shortage. MACPAC is engaged in ongoing work focused on streamlining access to and incentivizing HCBS. The presenters will share preliminary work on considerations in redesigning the Medicaid HCBS benefit, and separately takeaways from a recently released issue brief on HCBS workforce shortages.  

About the Speakers:

Kirstin Blom, MIPA, is the contracting officer and a principal analyst. Before joining MACPAC, Ms. Blom was an analyst in health care financing at the Congressional Research Service. Before that, Ms. Blom worked as a principal analyst at the Congressional Budget Office, where she estimated the cost of proposed legislation on the Medicaid program. Ms. Blom has also been an analyst for the Medicaid program in Wisconsin and for the U.S. Government Accountability Office (GAO). She holds a master of international public affairs from the University of Wisconsin, Madison, and a bachelor of arts in international studies and Spanish from the University of Wisconsin.

Asmaa Albaroudi, MSG, is a senior analyst. Prior to joining MACPAC, she was a Health and Aging Policy Fellow with the House Energy and Commerce Committee’s Subcommittee on Health. Ms. Albaroudi also worked as the manager of quality and policy initiatives at the National PACE Association, where she provided research and analysis on federal and state regulations. She is currently a doctoral candidate at the University of Maryland-College Park’s School of Public Health, where her research centers on long term care. Ms. Albaroudi holds a master of science in gerontology and a bachelor of science in human development and aging from the University of Southern California.

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Education Pathways for Direct Care Workers:

Tools for Recruitment, Retention and Worker Satisfaction

Jessica Jones,  Outcomes Manager, CareAcademy
Over 4.5 million direct care workers provide daily support to people with disabilities and aging adults needing long term services and supports.  As our population continues to age, and as the ability and availability of family care continues to fall short, the struggle to fill and maintain direct care positions and stabilize this essential workforce will continue.  To learn more about strategies to better address these challenges, CareAcademy conducted a survey in August/September 2021 of 1,500 direct care workers  nationwide to assess their educational and career aspirations.

Survey participants were asked about their educational aspirations; their responses provided insights on caregivers’ interest in pursuing further education, the barriers they face in doing so, and the role they would like to see their  employers take in promoting workers’ educational attainment.  An important component of the study was learning the impact that employer investment in worker education might have on recruitment and retention and worker satisfaction.  The presentation will discuss key findings from the report and how CareAcademy plans to provide tools to home care provider organizations that can help open new doors for direct care workers to advance their careers and thus, strengthen the workforce.

Link to the survey report - https://careacademy.com/caregiver-education/

About the Speaker:

Jessica Jones, Outcomes Manager at CareAcademy, oversees the design and implementation of CareAcademy’s processes for measuring caregiver and care recipient outcomes. As an experienced long term care researcher, she is passionate about linking better quality care for older adults to the services that lend them and their families the support needed to better age in place. Prior to CareAcademy, Jessica worked for RTI International, an independent, nonprofit institute that provides research, development, and technical services to government and commercial clients worldwide. She was assistant project manager and analyst for the evaluation of a CMS nursing facility initiative focused on capacity-building interventions to reduce avoidable hospitalizations—a model that impacted residents and staff in over 250 facilities across eight states. Jessica holds an
undergraduate degree in math and political science from Emory University

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Findings from the Society of Actuaries Risks and Process of Retirement Survey and Other Consumer Research 

Speaker: Anna Rappaport and Barbara Hogg
The newly released 2021 Retirement Risk Survey is designed to understand the current state of retirement in the United States from an individual’s perspective.  An additional SOA study, Financial Perspectives on Aging and Retirement Across the Generations, provides insight on a broad range of financial security issues across the generations.  These studies addresses Americans’ retirement and financial concerns and preparedness, their financial priorities, and how they plan for change in retirement, the impact of shocks and unexpected events, and their views on health and caregiving. Thsese online surveys of Americans were conducted in 2021 by Greenwald Research on behalf of the Society of Actuaries Research Institute (SOA). Both offer insights on the impact of COVID-19 and on differences by race and ethnicity. The presentation will discuss some key findings with a focus on the impact of COVID-19, and on how people are doing in the current environment.

About the Speakers:

Anna Rappaport is an actuary, consultant, author, and a nationally and internationally recognized expert and speaker on the impact of change on retirement systems and workforce issues. She is passionate about improving retirement security and opportunities for older Americans. She has focused on women’s security, disability and defined contribution plans, phased retirement, and improving individuals’ ability to plan. Anna is a past- President of the SOA and chairs the Committee on Post-Retirement Needs and Risks. She writes for the SOA Retirement Section News, The Conference Board’s Human Capital Exchange and Forbes. She formed Anna Rappaport Consulting in 2005 after retiring from 28 years at Mercer.  She is a Fellow of the Society of Actuaries and a member of the American Academy of Actuaries. She has an MBA from the University of Chicago Booth School of Business. Anna received the Lifetime Achievement Award in 2017 from the Plan Sponsor Council of America, the 2018 Lillywhite Award from EBRI, and the SOA Lifetime Volunteer Award in 2021. She serves on the Advisory Board of the Pension Research Council and the Board of the Women’s Institute for a Secure Retirement (WISER).

Barbara Hogg is a partner in Aon’s Lincolnshire, IL office.  She chaired the Project Oversight Committee for the 2021 Society of Actuaries Retirement Risk Survey.  With over 30 years experience, Barb is a retirement consultant focusing on a broad range of retirement issues including detailed plan design, retirement readiness, and participant communication.   She is knowledgeable about both the plan sponsor and the participant perspective, about both Defined Benefit (DB) and Defined Contribution (DC) plans, and has extensive research experience.

Barb is involved in Aon’s retirement thought leadership efforts to identify trends in retirement program design, especially DC plans. Recently, she has helped develop and launch Aon’s Employee DC and Financial Wellbeing Employee Survey and Aon’s DC Employer Survey.

For several years, Barb led Aon’s retirement communication efforts—providing strategic leadership, working directly with clients to create retirement communication strategies, and developing participant communication materials to support administrative services. She continues to help guide communication and participant education related to retirement plans and pension settlement strategies.

Barb has a B.A. degree from the University of Iowa in Economics and Statistics and an M.S. from Northwestern in Statistics. She is a fellow of the Society of Actuaries.

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Meeting ID: Meeting ID: 986 2455 5415

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Speaker(s):

Robyn Grant, MSW, Director, Public Policy and Advocacy, National Consumer Voice for Quality Long-Term Care

Topic:

Chronic understaffing has been a serious problem in nursing homes for decades, and has been exacerbated by the COVID-19 pandemic. The research indicates that inadequate staffing contributes to lower quality of care and poor health outcomes for residents. Yet no federal staffing standard exists, and only one state requires a minimum research-backed standard of 4.1 hours per resident day.

Our speaker(s) will provide an overview of a new report documenting staffing standards in each state and analyzing the contrast to research-based standards recommended by medical and healthcare professionals to ensure quality of care. The session will discuss the research and data supporting the need for a federal minimum staffing standard.

About the Speaker(s):

Robyn Grant

Robyn Grant is the Director of Public Policy and Advocacy at the National Consumer Voice for Quality Long-Term Care. In this capacity, she is responsible for leading the development and implementation of the Consumer Voice’s public policy agenda and growing and mobilizing the grassroots network to support the organization’s policy work.  Prior to assuming this role, Robyn was the Director of Advocacy and Outreach. Before joining the Consumer Voice, she served as the Long Term Care Policy Director at United Senior Action, an Indiana senior advocacy organization, and a consultant with the National Long-Term Care Ombudsman Resource Center. She has a Master’s in Social Work with a specialization in aging. She was the Indiana State Long-Term Care Ombudsman for eight years and president of the National Association of State Long-Term Care Ombudsman Programs for two terms. Robyn has also served on the Consumer Voice Board of Directors.

The meeting materials will also be posted (once available) on the PRESENTATION MATERIALS page.

Long Term Care Discussion Group meetings are intended as forums for candid discussion. Dialogue and comments made during these meetings should be treated as off the record.

For more information about the Long Term Care Discussion Group, and for materials and information relating to previous meetings, visit www.ltcdiscussiongroup.org

SAVE THE DATE NOTIFICATIONS ARE DISTRIBUTED COURTESY OF AMERICA'S HEALTH INSURANCE PLANS (AHIP). If you are not on the e-mail distribution list and wish to be added to it, please contact us at ltcdiscussiongroup@gmail.com

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Meeting ID: Meeting ID: 986 2455 5415

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Speakers:

Robyn Grant, National Consumer Voice for Quality Long-Term Care

Charlene Harrington, Ph.D., RN, School of Nursing, University of California, San Francisco

Richard Mollot, Long Term Care Community Coalition

Topic:

Chronic understaffing has been a serious problem in nursing homes for decades, and has been exacerbated by the COVID-19 pandemic. The research indicates that inadequate staffing contributes to lower quality of care and poor health outcomes for residents. Yet no federal staffing standard exists, and only one state requires a minimum research-backed standard of 4.1 hours per resident day.

Our speakers will provide an overview of a new report documenting staffing standards in each state and analyzing the contrast to research-based standards recommended by medical and healthcare professionals to ensure quality of care. The session will also discuss the research and data supporting the need for a federal minimum staffing standard.

About the Speaker(s):

Robyn Grant

Robyn Grant is the Director of Public Policy and Advocacy at the National Consumer Voice for Quality Long-Term Care. In this capacity, she is responsible for leading the development and implementation of the Consumer Voice’s public policy agenda and growing and mobilizing the grassroots network to support the organization’s policy work.  Prior to assuming this role, Robyn was the Director of Advocacy and Outreach. Before joining the Consumer Voice, she served as the Long Term Care Policy Director at United Senior Action, an Indiana senior advocacy organization, and a consultant with the National Long-Term Care Ombudsman Resource Center. She has a Master’s in Social Work with a specialization in aging. She was the Indiana State Long-Term Care Ombudsman for eight years and president of the National Association of State Long-Term Care Ombudsman Programs for two terms. Robyn has also served on the Consumer Voice Board of Directors.

Dr. Harrington is a gerontologist who has been a professor of sociology and nursing at the University of California San Francisco since 1980.  She was elected to the American Academy of Nursing and the National Academies of Medicine.  Her research has focused on long term care consumer information systems; home and community-and service programs and policies; nursing home quality, staffing, regulation, ownership and financing; and international nursing home research with colleagues in 6 countries. Dr. Harrington is a member of the Centers for Medicare and Medicaid Technical Advisory Committee for the Medicare Nursing Home Compare website, serves on editorial boards, has testified before Congress, and has written more than 250 articles and books. During the pandemic, she has conducted research on nursing homes and Covid-19 infections and written commentaries on staffing, transparency, financial issues, and nursing home redesign.

Richard Mollot is the executive director of the Long Term Care Community Coalition (LTCCC), a U.S.-based nonpartisan, nonprofit organization dedicated to improving care for individuals in nursing homes and other residential care settings through legal and policy research, advocacy, and education.  Richard has researched and published on a variety of long-term care issues, including: dementia care; nursing home and assisted living standards; the rights of older adults in residential care; abuse, neglect, and crime in nursing homes; nursing home financing; and the imposition and use of penalties for substandard residential care. He is a graduate of Howard University School of Law and a member of the Maryland Bar.

The meeting materials will also be posted (once available) on the PRESENTATION MATERIALS page.

Long Term Care Discussion Group meetings are intended as forums for candid discussion. Dialogue and comments made during these meetings should be treated as off the record.

For more information about the Long Term Care Discussion Group, and for materials and information relating to previous meetings, visit www.ltcdiscussiongroup.org

SAVE THE DATE NOTIFICATIONS ARE DISTRIBUTED COURTESY OF AMERICA'S HEALTH INSURANCE PLANS (AHIP). If you are not on the e-mail distribution list and wish to be added to it, please contact us at ltcdiscussiongroup@gmail.com